The comparison of various ablation technics in treatment of endometrial hyperplastic processes
Popov A.A., Aliyeva A.S., Manannikova T.N., Barto R.A.

Moscow Regional Research Institute of Obstetrics and Gynaecology

Aim: a comparative evaluation of the effectiveness of transcervical resection, endometrial thermal balloon and microwave ablation in women of perimenopausal age with endometrial hyperplastic processes without atypia. 
Patients and methods: 85 women with endometrial hyperplastic processes underwent an organ preservation surgery. Before surgery, 92% of women reported abnormal uterine bleeding of hyperpolymenorrhea type. Patients were divided into 3 groups: the I group consisted of 30 patients who underwent surgical treatment in the volume of transcervical resection of the endometrium (TCRE), 25 patients entered the group II, with the endometrial thermal ablation using the «Thermachoise» technology, and the III group included 30 women who underwent endometrial microwave ablation (EMA) with the use of «Microsulis» technology. The patients of group I were operated under endotracheal anesthesia, patients of the groups II and III - under general intravenous anesthesia. In the postoperative period, ultrasound examination was performed after 14 days, 3 months and 1 year. To assess the quality of life of patients the questionnaire QoL SF (Quality of Life, Short Form) was used. 
Results: after transcervical resection of the endometrium the amenorrhea was observed in 87% of cases, after thermal ablation - in 80%, after EMA - in 70% of patients. Menstruations of opsomenorrhea type were noted in 16% of the patients of the group II and in 23% of women in the group III. In 10, 4 and 7% of patients of the groups respectively, a relapse was observed during the follow-up period of up to 18 months. Thus, at the end of the follow-up period, 87% of the patients in the transcervical endometrial resection group, 96% of the patients of the group of endometrial thermal balloon ablation by «Thermachoise» technology and 93.3% of the women of the «Microsulis» endometrial microwaving group were satisfied with the results of the treatment.
Conclusion: all three methods demonstrated high treatment effectiveness and patients’ satisfaction with the quality of life. The choice of ablative technology depends first of all on surgeon’s preferences and equipment of the operating room.

Key words: endometrial hyperplastic processes, endometrial hyperplasia, transcervical resection of the endometrium, endometrial thermal balloon ablation, endometrial microwave ablation, perimenopausе.
For citation: Popov A.A., Aliyeva A.S., Manannikova T.N., Barto R.A. The comparison of various ablation technics in treatment of endometrial hyperplastic processes // RMJ. 2017. № 26. P. 1942–1945.