Gas embolism during hysteroscopic surgery using bipolar or monopolar diathermia: a randomized controlled trial
Objective The objective of the study was to determine the incidence and amount of gas embolism during hysteroscopic surgery using either monopolar or bipolar diathermia and to investigate the relationship between the severity of gas embolism and the amount of intravasation of distension fluid. Study...
Gespeichert in:
| Veröffentlicht in: | American journal of obstetrics and gynecology 2012-10, Vol.207 (4), p.271.e1-271.e6 |
|---|---|
| Hauptverfasser: | , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 271.e6 |
|---|---|
| container_issue | 4 |
| container_start_page | 271.e1 |
| container_title | American journal of obstetrics and gynecology |
| container_volume | 207 |
| creator | Dyrbye, Birgitte A., MD Overdijk, Lucilla E., MD van Kesteren, Paul J., MD, PhD de Haan, Peter, MD, PhD Riezebos, Robert K., MD, PhD Bakkum, Erica A., MD, PhD Rademaker, Bart M., MD, PhD |
| description | Objective The objective of the study was to determine the incidence and amount of gas embolism during hysteroscopic surgery using either monopolar or bipolar diathermia and to investigate the relationship between the severity of gas embolism and the amount of intravasation of distension fluid. Study Design This was a randomized, observer-blinded trial. Fifty patients, scheduled for hysteroscopic surgery, were assigned to either monopolar or bipolar diathermia. Transesophageal echocardiography was used to detect and classify gas embolism (grade 0-IV). Intravasation of distension fluid was measured. Results Venous gas embolism was observed in all but 1 patient. A higher incidence of more extensive (grade IV) was seen during bipolar diathermia (42% vs 13%; P = .031). Paradoxical embolism was observed in 2 patients. When intravasation exceeded 1000 mL, significantly more grade IV venous gas embolism was seen ( P = .049). Conclusion During hysteroscopic surgery, gas embolism was equally observed irrespective of the type of diathermia. However, more extensive embolism was observed when intravasation of distension fluid exceeded 1 L. These results question the acceptance of up to 2500 mL intravasation of distension fluid if bipolar diathermia is used. |
| doi_str_mv | 10.1016/j.ajog.2012.07.027 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1081874496</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S000293781200779X</els_id><sourcerecordid>1081874496</sourcerecordid><originalsourceid>FETCH-LOGICAL-c441t-fdaa7ea480f5c26665af463f85d36a90637cb5d356c0b36faa050ea64cd25ebd3</originalsourceid><addsrcrecordid>eNp9kkGL1TAQgIMo7nP1D3iQXAQvrUnaJq3Igiy6CgseVPAWpsn0bWraPJNWeP56U95TwYOnmZBvZpKPIeQpZyVnXL4cSxjDvhSMi5Kpkgl1j-w461QhW9neJzvGmCi6SrUX5FFK43YUnXhILraQwXZH5htIFKc-eJcmatfo5j29O6YFY0gmHJyhaY17jEe6pu2ud4fgIdIQ6RTmcDpYB8sdxsnBKwo0wmzD5H6ipSbMSwze53SJDvxj8mAAn_DJOV6SL-_efr5-X9x-vPlw_ea2MHXNl2KwAAqhbtnQGCGlbGCoZTW0ja0kdExWyvQ5b6RhfSUHANYwBFkbKxrsbXVJXpz6HmL4vmJa9OSSQe9hxrAmzVnLW1XXncyoOKEm_zhFHPQhugniMUN686xHvXnWm2fNlM6ec9Gzc_-1n9D-KfktNgPPzwAkA37IToxLfzmZZ3dSZO71icNs44fDqJNxOBu0LqJZtA3u_--4-qfceDe7PPEbHjGNYY1z9qy5TrlGf9pWYFsILhhTqvta_QJkJrNA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1081874496</pqid></control><display><type>article</type><title>Gas embolism during hysteroscopic surgery using bipolar or monopolar diathermia: a randomized controlled trial</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Dyrbye, Birgitte A., MD ; Overdijk, Lucilla E., MD ; van Kesteren, Paul J., MD, PhD ; de Haan, Peter, MD, PhD ; Riezebos, Robert K., MD, PhD ; Bakkum, Erica A., MD, PhD ; Rademaker, Bart M., MD, PhD</creator><creatorcontrib>Dyrbye, Birgitte A., MD ; Overdijk, Lucilla E., MD ; van Kesteren, Paul J., MD, PhD ; de Haan, Peter, MD, PhD ; Riezebos, Robert K., MD, PhD ; Bakkum, Erica A., MD, PhD ; Rademaker, Bart M., MD, PhD</creatorcontrib><description>Objective The objective of the study was to determine the incidence and amount of gas embolism during hysteroscopic surgery using either monopolar or bipolar diathermia and to investigate the relationship between the severity of gas embolism and the amount of intravasation of distension fluid. Study Design This was a randomized, observer-blinded trial. Fifty patients, scheduled for hysteroscopic surgery, were assigned to either monopolar or bipolar diathermia. Transesophageal echocardiography was used to detect and classify gas embolism (grade 0-IV). Intravasation of distension fluid was measured. Results Venous gas embolism was observed in all but 1 patient. A higher incidence of more extensive (grade IV) was seen during bipolar diathermia (42% vs 13%; P = .031). Paradoxical embolism was observed in 2 patients. When intravasation exceeded 1000 mL, significantly more grade IV venous gas embolism was seen ( P = .049). Conclusion During hysteroscopic surgery, gas embolism was equally observed irrespective of the type of diathermia. However, more extensive embolism was observed when intravasation of distension fluid exceeded 1 L. These results question the acceptance of up to 2500 mL intravasation of distension fluid if bipolar diathermia is used.</description><identifier>ISSN: 0002-9378</identifier><identifier>EISSN: 1097-6868</identifier><identifier>DOI: 10.1016/j.ajog.2012.07.027</identifier><identifier>PMID: 22921098</identifier><identifier>CODEN: AJOGAH</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Adolescent ; Adult ; Aged ; Biological and medical sciences ; Blood and lymphatic vessels ; Cardiology. Vascular system ; diathermia ; Diathermy - adverse effects ; Diathermy - methods ; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous ; Embolism, Air - etiology ; Female ; gas embolism ; Gynecology. Andrology. Obstetrics ; Humans ; hysteroscopy ; Hysteroscopy - adverse effects ; Hysteroscopy - methods ; Leiomyoma - surgery ; Medical sciences ; Menorrhagia - surgery ; Middle Aged ; Obstetrics and Gynecology ; transcervical resection of myoma or endometrium ; transesophageal echocardiography ; Uterine Neoplasms - surgery</subject><ispartof>American journal of obstetrics and gynecology, 2012-10, Vol.207 (4), p.271.e1-271.e6</ispartof><rights>Mosby, Inc.</rights><rights>2012 Mosby, Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2012 Mosby, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c441t-fdaa7ea480f5c26665af463f85d36a90637cb5d356c0b36faa050ea64cd25ebd3</citedby><cites>FETCH-LOGICAL-c441t-fdaa7ea480f5c26665af463f85d36a90637cb5d356c0b36faa050ea64cd25ebd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ajog.2012.07.027$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,45974</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26449962$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22921098$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dyrbye, Birgitte A., MD</creatorcontrib><creatorcontrib>Overdijk, Lucilla E., MD</creatorcontrib><creatorcontrib>van Kesteren, Paul J., MD, PhD</creatorcontrib><creatorcontrib>de Haan, Peter, MD, PhD</creatorcontrib><creatorcontrib>Riezebos, Robert K., MD, PhD</creatorcontrib><creatorcontrib>Bakkum, Erica A., MD, PhD</creatorcontrib><creatorcontrib>Rademaker, Bart M., MD, PhD</creatorcontrib><title>Gas embolism during hysteroscopic surgery using bipolar or monopolar diathermia: a randomized controlled trial</title><title>American journal of obstetrics and gynecology</title><addtitle>Am J Obstet Gynecol</addtitle><description>Objective The objective of the study was to determine the incidence and amount of gas embolism during hysteroscopic surgery using either monopolar or bipolar diathermia and to investigate the relationship between the severity of gas embolism and the amount of intravasation of distension fluid. Study Design This was a randomized, observer-blinded trial. Fifty patients, scheduled for hysteroscopic surgery, were assigned to either monopolar or bipolar diathermia. Transesophageal echocardiography was used to detect and classify gas embolism (grade 0-IV). Intravasation of distension fluid was measured. Results Venous gas embolism was observed in all but 1 patient. A higher incidence of more extensive (grade IV) was seen during bipolar diathermia (42% vs 13%; P = .031). Paradoxical embolism was observed in 2 patients. When intravasation exceeded 1000 mL, significantly more grade IV venous gas embolism was seen ( P = .049). Conclusion During hysteroscopic surgery, gas embolism was equally observed irrespective of the type of diathermia. However, more extensive embolism was observed when intravasation of distension fluid exceeded 1 L. These results question the acceptance of up to 2500 mL intravasation of distension fluid if bipolar diathermia is used.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Cardiology. Vascular system</subject><subject>diathermia</subject><subject>Diathermy - adverse effects</subject><subject>Diathermy - methods</subject><subject>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</subject><subject>Embolism, Air - etiology</subject><subject>Female</subject><subject>gas embolism</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>hysteroscopy</subject><subject>Hysteroscopy - adverse effects</subject><subject>Hysteroscopy - methods</subject><subject>Leiomyoma - surgery</subject><subject>Medical sciences</subject><subject>Menorrhagia - surgery</subject><subject>Middle Aged</subject><subject>Obstetrics and Gynecology</subject><subject>transcervical resection of myoma or endometrium</subject><subject>transesophageal echocardiography</subject><subject>Uterine Neoplasms - surgery</subject><issn>0002-9378</issn><issn>1097-6868</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kkGL1TAQgIMo7nP1D3iQXAQvrUnaJq3Igiy6CgseVPAWpsn0bWraPJNWeP56U95TwYOnmZBvZpKPIeQpZyVnXL4cSxjDvhSMi5Kpkgl1j-w461QhW9neJzvGmCi6SrUX5FFK43YUnXhILraQwXZH5htIFKc-eJcmatfo5j29O6YFY0gmHJyhaY17jEe6pu2ud4fgIdIQ6RTmcDpYB8sdxsnBKwo0wmzD5H6ipSbMSwze53SJDvxj8mAAn_DJOV6SL-_efr5-X9x-vPlw_ea2MHXNl2KwAAqhbtnQGCGlbGCoZTW0ja0kdExWyvQ5b6RhfSUHANYwBFkbKxrsbXVJXpz6HmL4vmJa9OSSQe9hxrAmzVnLW1XXncyoOKEm_zhFHPQhugniMUN686xHvXnWm2fNlM6ec9Gzc_-1n9D-KfktNgPPzwAkA37IToxLfzmZZ3dSZO71icNs44fDqJNxOBu0LqJZtA3u_--4-qfceDe7PPEbHjGNYY1z9qy5TrlGf9pWYFsILhhTqvta_QJkJrNA</recordid><startdate>20121001</startdate><enddate>20121001</enddate><creator>Dyrbye, Birgitte A., MD</creator><creator>Overdijk, Lucilla E., MD</creator><creator>van Kesteren, Paul J., MD, PhD</creator><creator>de Haan, Peter, MD, PhD</creator><creator>Riezebos, Robert K., MD, PhD</creator><creator>Bakkum, Erica A., MD, PhD</creator><creator>Rademaker, Bart M., MD, PhD</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20121001</creationdate><title>Gas embolism during hysteroscopic surgery using bipolar or monopolar diathermia: a randomized controlled trial</title><author>Dyrbye, Birgitte A., MD ; Overdijk, Lucilla E., MD ; van Kesteren, Paul J., MD, PhD ; de Haan, Peter, MD, PhD ; Riezebos, Robert K., MD, PhD ; Bakkum, Erica A., MD, PhD ; Rademaker, Bart M., MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c441t-fdaa7ea480f5c26665af463f85d36a90637cb5d356c0b36faa050ea64cd25ebd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Cardiology. Vascular system</topic><topic>diathermia</topic><topic>Diathermy - adverse effects</topic><topic>Diathermy - methods</topic><topic>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</topic><topic>Embolism, Air - etiology</topic><topic>Female</topic><topic>gas embolism</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>hysteroscopy</topic><topic>Hysteroscopy - adverse effects</topic><topic>Hysteroscopy - methods</topic><topic>Leiomyoma - surgery</topic><topic>Medical sciences</topic><topic>Menorrhagia - surgery</topic><topic>Middle Aged</topic><topic>Obstetrics and Gynecology</topic><topic>transcervical resection of myoma or endometrium</topic><topic>transesophageal echocardiography</topic><topic>Uterine Neoplasms - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dyrbye, Birgitte A., MD</creatorcontrib><creatorcontrib>Overdijk, Lucilla E., MD</creatorcontrib><creatorcontrib>van Kesteren, Paul J., MD, PhD</creatorcontrib><creatorcontrib>de Haan, Peter, MD, PhD</creatorcontrib><creatorcontrib>Riezebos, Robert K., MD, PhD</creatorcontrib><creatorcontrib>Bakkum, Erica A., MD, PhD</creatorcontrib><creatorcontrib>Rademaker, Bart M., MD, PhD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of obstetrics and gynecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dyrbye, Birgitte A., MD</au><au>Overdijk, Lucilla E., MD</au><au>van Kesteren, Paul J., MD, PhD</au><au>de Haan, Peter, MD, PhD</au><au>Riezebos, Robert K., MD, PhD</au><au>Bakkum, Erica A., MD, PhD</au><au>Rademaker, Bart M., MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Gas embolism during hysteroscopic surgery using bipolar or monopolar diathermia: a randomized controlled trial</atitle><jtitle>American journal of obstetrics and gynecology</jtitle><addtitle>Am J Obstet Gynecol</addtitle><date>2012-10-01</date><risdate>2012</risdate><volume>207</volume><issue>4</issue><spage>271.e1</spage><epage>271.e6</epage><pages>271.e1-271.e6</pages><issn>0002-9378</issn><eissn>1097-6868</eissn><coden>AJOGAH</coden><abstract>Objective The objective of the study was to determine the incidence and amount of gas embolism during hysteroscopic surgery using either monopolar or bipolar diathermia and to investigate the relationship between the severity of gas embolism and the amount of intravasation of distension fluid. Study Design This was a randomized, observer-blinded trial. Fifty patients, scheduled for hysteroscopic surgery, were assigned to either monopolar or bipolar diathermia. Transesophageal echocardiography was used to detect and classify gas embolism (grade 0-IV). Intravasation of distension fluid was measured. Results Venous gas embolism was observed in all but 1 patient. A higher incidence of more extensive (grade IV) was seen during bipolar diathermia (42% vs 13%; P = .031). Paradoxical embolism was observed in 2 patients. When intravasation exceeded 1000 mL, significantly more grade IV venous gas embolism was seen ( P = .049). Conclusion During hysteroscopic surgery, gas embolism was equally observed irrespective of the type of diathermia. However, more extensive embolism was observed when intravasation of distension fluid exceeded 1 L. These results question the acceptance of up to 2500 mL intravasation of distension fluid if bipolar diathermia is used.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>22921098</pmid><doi>10.1016/j.ajog.2012.07.027</doi><tpages>2</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0002-9378 |
| ispartof | American journal of obstetrics and gynecology, 2012-10, Vol.207 (4), p.271.e1-271.e6 |
| issn | 0002-9378 1097-6868 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1081874496 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Adolescent Adult Aged Biological and medical sciences Blood and lymphatic vessels Cardiology. Vascular system diathermia Diathermy - adverse effects Diathermy - methods Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous Embolism, Air - etiology Female gas embolism Gynecology. Andrology. Obstetrics Humans hysteroscopy Hysteroscopy - adverse effects Hysteroscopy - methods Leiomyoma - surgery Medical sciences Menorrhagia - surgery Middle Aged Obstetrics and Gynecology transcervical resection of myoma or endometrium transesophageal echocardiography Uterine Neoplasms - surgery |
| title | Gas embolism during hysteroscopic surgery using bipolar or monopolar diathermia: a randomized controlled trial |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-22T05%3A21%3A49IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Gas%20embolism%20during%20hysteroscopic%20surgery%20using%20bipolar%20or%20monopolar%20diathermia:%20a%20randomized%20controlled%20trial&rft.jtitle=American%20journal%20of%20obstetrics%20and%20gynecology&rft.au=Dyrbye,%20Birgitte%20A.,%20MD&rft.date=2012-10-01&rft.volume=207&rft.issue=4&rft.spage=271.e1&rft.epage=271.e6&rft.pages=271.e1-271.e6&rft.issn=0002-9378&rft.eissn=1097-6868&rft.coden=AJOGAH&rft_id=info:doi/10.1016/j.ajog.2012.07.027&rft_dat=%3Cproquest_cross%3E1081874496%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1081874496&rft_id=info:pmid/22921098&rft_els_id=1_s2_0_S000293781200779X&rfr_iscdi=true |