IBS在子宫内膜息肉诊疗中的应用和进展
Application and Progress of IBS in the Diagnosis and Treatment of Endometrial Polyps
DOI: 10.12677/md.2026.162029, PDF,   
作者: 张博莹:延安大学医学院,陕西 延安;钱延玲*:延安大学附属医院妇产科,陕西 延安
关键词: 子宫内膜息肉宫腔镜宫内刨削系统诊治进展良性病变Endometrial Polyps Hysteroscopy Intrauterine Shaving System Diagnosis and Treatment Progress Benign Lesions
摘要: 子宫内膜息肉已逐渐成为女性中一种普遍的妇科疾病,其发生率逐年上升,可能引发月经不规律和不孕等一系列并发症。因此,深入研究该病的诊断和治疗显得尤为关键。近年来,子宫内膜息肉的治疗手段取得了显著进展,但传统的宫腔镜手术技术仍面临视野受限和热损伤等问题,这些问题对治疗效果和患者安全产生了影响。随着医学技术的不断提升,宫内刨削系统(IBS)的引入为子宫内膜息肉的诊断与治疗提供了一个更为安全有效的替代方案。本文综述了子宫内膜息肉的病理生理特征、临床表现、诊断方法以及当前的治疗现状,特别关注IBS的应用效果及其在临床实践中的潜力。通过对相关文献的分析,本文总结了IBS在治疗子宫内膜息肉及其他宫腔内病变中的优势与挑战,并探讨了其未来的发展方向及临床应用的前景,旨在为相关研究提供参考,改善患者的治疗效果与生活质量。
Abstract: Endometrial polyps have gradually become a common gynecological disease among women, with their incidence increasing year by year, potentially leading to a series of complications such as irregular menstruation and infertility. Therefore, in-depth research on the diagnosis and treatment of this disease is particularly crucial. In recent years, significant progress has been made in the treatment methods for endometrial polyps, but traditional hysteroscopic surgical techniques still face issues such as limited field of view and thermal damage, which affect treatment outcomes and patient safety. With the continuous advancement of medical technology, the introduction of the Intrauterine Bigatti Shaver (IBS) system provides a safer and more effective alternative for the diagnosis and treatment of endometrial polyps. This article reviews the pathophysiological characteristics, clinical picture, diagnostic methods, and current treatment status of endometrial polyps, with a particular focus on the application effects of IBS and its potential in clinical practice. Through the analysis of relevant literature, this article summarizes the advantages and challenges of IBS in treating endometrial polyps and other intrauterine lesions, and explores its future development directions and clinical application prospects, aiming to provide references for related research and improve patient treatment outcomes and quality of life.
文章引用:张博莹, 钱延玲. IBS在子宫内膜息肉诊疗中的应用和进展[J]. 医学诊断, 2026, 16(2): 214-223. https://doi.org/10.12677/md.2026.162029

参考文献

[1] Akış, S., Kıran, G. and Göçmen, A. (2021) The Clinical Importance of Polyp Size Measurement through Two‐Dimensional Saline Infusion Sonohysterography Prior to Hysteroscopic Resection in Predicting Premalignant and Malignant Endometrial Lesions. International Journal of Gynecology & Obstetrics, 157, 582-587. [Google Scholar] [CrossRef] [PubMed]
[2] Wang, C., Lu, Y., Ou, M., Qian, L., Zhang, Y., Yang, Y., et al. (2025) Risk Factors for Recurrent Implantation Failure as Defined by the European Society for Human Reproduction and Embryology. Human Reproduction, 40, 1138-1147. [Google Scholar] [CrossRef] [PubMed]
[3] Liu, M., Liang, Y. and Jin, E. (2024) Endometrial Carcinoma with Cervical Stromal Invasion: Three Case Reports. World Journal of Clinical Cases, 12, 5583-5588. [Google Scholar] [CrossRef] [PubMed]
[4] Hermansyah, D., Anas, M., Yaznil, M., Lubis, A. and Alianto, R. (2024) Tamoxifen-Associated Endometrial Cancer after Treatment in Young Premenopausal Women with Breast Cancer: A Case Report. Acta Informatica Medica, 32, 85-87. [Google Scholar] [CrossRef] [PubMed]
[5] Rotenberg, O., Doulaveris, G., Fridman, D., Renz, M., Kaplan, J., Xie, X., et al. (2023) Risk of Endometrial Polyp and Surgical Intervention in Postmenopausal Women with Proliferative Endometrium. Maturitas, 178, Article ID: 107847. [Google Scholar] [CrossRef] [PubMed]
[6] Török, P., Molnár, S., Lampé, R. and Jakab, A. (2020) The Use of Hysteroscopy in Endometrial Cancer: Old Questions and Novel Challenges. Climacteric, 23, 330-335. [Google Scholar] [CrossRef] [PubMed]
[7] Sharon, A., Zidane, M., Aiob, A., Apel-Sarid, L. and Bornstein, J. (2023) Nonelectric Shaving of Endometrial Polyp by Hysteroscopy—A New Technique to Eliminate Thermal Damage. European Journal of Obstetrics & Gynecology and Reproductive Biology, 285, 170-174. [Google Scholar] [CrossRef] [PubMed]
[8] Yan, C., Xing, C., Wei, T., Zhou, H., Wang, H., Liu, T., et al. (2023) Impact of Estrogen and Progesterone Receptor Expression on the Incidence of Endometrial Polyps. Biomarkers in Medicine, 17, 881-887. [Google Scholar] [CrossRef] [PubMed]
[9] Arif, S.H., Mohammed, A.A. and Mohammed, F.R. (2020) Metastatic Invasive Lobular Carcinoma of the Breast to the Endometrium Presenting with Abnormal Uterine Bleeding; Case Report. Annals of Medicine and Surgery, 51, 41-43. [Google Scholar] [CrossRef] [PubMed]
[10] Simonsen, M., Mantoan, H., Faloppa, C.C., Kumagai, L.Y., Badiglian Filho, L., Machado, A.G., et al. (2021) Residual Disease after Operative Hysteroscopy in Patients with Endometrioid Endometrial Cancer Associated with Polyps. Revista Brasileira de Ginecologia e Obstetrícia/RBGO Gynecology and Obstetrics, 43, 35-40. [Google Scholar] [CrossRef] [PubMed]
[11] Sidera, A., Matalliotakis, M., Tsakiridis, I., Matalliotaki, C., Krithinakis, K., Dagklis, T., et al. (2025) Coexistence of Gynecological Pathologies in Women with Cervical and Endometrial Polyps. Cureus, 17, e77015. [Google Scholar] [CrossRef] [PubMed]
[12] Bulutay, P., Bilir, E., Yıldız, Ş. and Ata, B. (2022) Epidermal Growth Factor Receptor-Mutated Lung Adenocarcinoma Diagnosed from Endometrial Polyp Metastasis: A Case Report and Literature Review. Journal of Turkish Society of Obstetric and Gynecology, 19, 81-86. [Google Scholar] [CrossRef] [PubMed]
[13] Borthakur, K. (2024) Osseous Metaplasia of the Endometrium—Pre‐ and Post‐hysteroscopy Imaging Findings in a Hemiuterus: A Case Report. Journal of Clinical Ultrasound, 52, 1172-1175. [Google Scholar] [CrossRef] [PubMed]
[14] Tcherniakovsky, M., de Oliveira, E., Martinelli Sonnenfeld, M., Arcoverde Cavalcanti Meniconi, M.M., Franco de Oliveira, M., Tcherniakovsky, I., et al. (2023) Evaluation of COMT2, COMT3, CYP1B1, and ESR1 Gene Polymorphisms as Risk Factor for Endometrial Polyp. Women & Health, 63, 818-827. [Google Scholar] [CrossRef] [PubMed]
[15] Lu, M., Li, X., Niu, J. and Liu, B. (2022) LIN28B Polymorphisms Confer a Higher Postoperative Recurrence Risk in Reproductive-Age Women with Endometrial Polyps. Disease Markers, 2022, Article ID: 4824357. [Google Scholar] [CrossRef] [PubMed]
[16] Michalczyk, K., Kupnicka, P., Witczak, G., Tousty, P., Bosiacki, M., Kurzawski, M., et al. (2023) Assessment of Cadmium (Cd) and Lead (Pb) Blood Concentration on the Risk of Endometrial Cancer. Biology, 12, Article 717. [Google Scholar] [CrossRef] [PubMed]
[17] Tomczyk, K.M., Rzymski, P. and Wilczak, M. (2022) Canonical Analysis of Concentrations of Toxic Metals in Endometrium of Women with Gynecological Disorders. Ginekologia Polska, 93, 806-810. [Google Scholar] [CrossRef] [PubMed]
[18] Kossaï, M. and Penault-Llorca, F. (2020) Role of Hormones in Common Benign Uterine Lesions: Endometrial Polyps, Leiomyomas, and Adenomyosis. In: Deligdisch-Schor, L. and Mareş Miceli, A., Eds., Hormonal Pathology of the Uterus, Springer, 37-58. [Google Scholar] [CrossRef] [PubMed]
[19] Monti, E., Di Loreto, E., Libutti, G., Alberico, D., Barbara, G., Boero, V., et al. (2024) Clinical Significance of Atypical Glandular Cells on Cytology: 10 Years’ Experience of a Colposcopic Referral Center. European Journal of Cancer Prevention, 34, 106-112. [Google Scholar] [CrossRef] [PubMed]
[20] Donnez, J., Carmona, F., Maitrot-Mantelet, L., Dolmans, M. and Chapron, C. (2022) Uterine Disorders and Iron Deficiency Anemia. Fertility and Sterility, 118, 615-624. [Google Scholar] [CrossRef] [PubMed]
[21] Wong, M., Thanatsis, N., Nardelli, F., Amin, T. and Jurkovic, D. (2021) Risk of Pre-Malignancy or Malignancy in Postmenopausal Endometrial Polyps: A CHAID Decision Tree Analysis. Diagnostics, 11, Article 1094. [Google Scholar] [CrossRef] [PubMed]
[22] Wawire, J., Sung, C.J. and Quddus, M.R. (2023) Benign Biphasic Tumors of the Mullerian Tract—A Mimic of Phyllodes Tumor. A Clinical-Pathologic Description of 21 Cases. Annals of Clinical & Laboratory Science, 53, 641-646.
[23] Tekin, S., Ocal, A., Sisman, E., et al. (2024) Histological Assessment of Endometrial Polyps Resected by Hysteroscopy. European Review for Medical and Pharmacological Sciences, 28, 3241-3250.
[24] Nazari, L., Vahdat, M., Rokhgireh, S., Chaichian, S., Mehdizadehkashi, A., Aminzade, Z., et al. (2024) HPV Infection and Endometrial Polyps: Insights from a Case-Control Study. BMC Womens Health, 24, Article No. 598. [Google Scholar] [CrossRef] [PubMed]
[25] Meng, Q. (2024) Analysis of Ultrasonic Imaging Changes and Factors Related to Malignant Transformation in Postmenopausal Patients with Endometrial Polyps. American Journal of Translational Research, 16, 3055-3063. [Google Scholar] [CrossRef] [PubMed]
[26] Anees, F., Dur-e-Shahwar, Khan, R.S. and Khalid, T. (2025) Ruptured Uterine Pyomyoma with Multiorgan Dysfunction Syndrome. BMJ Case Reports, 18, e261454. [Google Scholar] [CrossRef] [PubMed]
[27] Huang, Y., Zhang, D., Zhang, L., Zhou, Y. and Peng, C. (2024) Clinical Efficacy of Dienogest against Endometriomas with a Maximum Diameter of ≥ 4 cm. Annals of Medicine, 56, Article ID: 2402942. [Google Scholar] [CrossRef] [PubMed]
[28] Kumar, N., Palo, S., Rath, A., Mangla, M. and Rathod, P. (2025) Subtle Intrusion: Minimal Serous Uterine Carcinoma in an Asymptomaticpostmenopausal Patient—A Case Report. Current Aging Science. [Google Scholar] [CrossRef] [PubMed]
[29] Vitagliano, A., Cialdella, M., Cicinelli, R., Santarsiero, C.M., Greco, P., Buzzaccarini, G., et al. (2021) Association between Endometrial Polyps and Chronic Endometritis: Is It Time for a Paradigm Shift in the Pathophysiology of Endometrial Polyps in Pre-Menopausal Women? Results of a Systematic Review and Meta-Analysis. Diagnostics, 11, Article 2182. [Google Scholar] [CrossRef] [PubMed]
[30] Wang, X., Zhang, H., Xu, J. and Qu, P. (2023) The Typical Polypoid Adenomyoma Is a Special Form of Endometrial Polyp: A Case-Controlled Study with a Large Sample Size. European Journal of Medical Research, 28, Article No. 308. [Google Scholar] [CrossRef] [PubMed]
[31] Benlghazi, A., Messaoudi, H., Benali, S., Tazi, I., Elhassani, M.M. and Kouach, J. (2024) Lobular Carcinoma Metastasis to Endometrial Polyps: Insights from a Case Report and Literature Analysis. International Journal of Surgery Case Reports, 124, Article ID: 110463. [Google Scholar] [CrossRef] [PubMed]
[32] Su, D., She, J., Xu, Y., Li, Y., Guo, Y., Yang, Y., et al. (2023) Case Report: Septic Shock after Endometrial Polypectomy with Tissue Removal System. BMC Womens Health, 23, Article No. 546. [Google Scholar] [CrossRef] [PubMed]
[33] Wang, Y., Cao, X., Fan, X. and Zhu, P. (2024) Clinical Efficacy Study of the IBS® (Intergrated Bigatti Shaver) Tissue Removal Device in the Treatment of Endometrial Polyps. World Journal of Surgical Oncology, 22, Article No. 321. [Google Scholar] [CrossRef] [PubMed]
[34] Li, F., Liang, Y., Luo, M. and Cheng, Y. (2022) A Rare Case of Endometrial Polyp Complicated with Uterine Inversion: A Case Report and Clinical Management. Open Medicine, 17, 550-555. [Google Scholar] [CrossRef] [PubMed]
[35] Jansen, F.W. and Van Dongen, H. (2008) Hysteroscopy: Useful in Diagnosis and Surgical Treatment of Intrauterine Lesions. Nederlands Tijdschrift voor Geneeskunde, 152, 1961-966.
[36] Tanos, V., Berry, K.E., Seikkula, J., Abi Raad, E., Stavroulis, A., Sleiman, Z., et al. (2017) The Management of Polyps in Female Reproductive Organs. International Journal of Surgery, 43, 7-16. [Google Scholar] [CrossRef] [PubMed]
[37] Zheng, F., Xin, X., He, F., Liu, J. and Cui, Y. (2020) Meta-Analysis on the Use of Hyaluronic Acid Gel to Prevent Intrauterine Adhesion after Intrauterine Operations. Experimental and Therapeutic Medicine, 19, 2672-2678. [Google Scholar] [CrossRef] [PubMed]
[38] Timmerman, S., Kerrebroeck, H.V., Ledger, A., Dewilde, K., Severen, R.V., den Bosch, T.V., et al. (2025) The Use of the 19fr. Intrauterine BIGATTI Shaver in Operative Hysteroscopy for Benign Intracavitary Lesions: A Feasibility Study. European Journal of Obstetrics & Gynecology and Reproductive Biology, 307, 197-202. [Google Scholar] [CrossRef] [PubMed]
[39] Martire, F.G., Schettini, G., Costantini, E., d’Abate, C., Sorrenti, G., Centini, G., et al. (2025) Approach to Abnormal Uterine Bleeding in Presence of Endometrial Polyps with New Hysteroscopic Devices. Archives of Gynecology and Obstetrics, 312, 257-265. [Google Scholar] [CrossRef] [PubMed]
[40] Zhang, D., Chen, Y., Zhang, L. and Wang, Y. (2025) The Effect of Acupoint Sticking Therapy on Serum Estrogen Levels and Endometrial Polyp Tissue Receptor Expression in Postmenopausal Patients with Endometrial Polyps. American Journal of Reproductive Immunology, 93, e70054. [Google Scholar] [CrossRef] [PubMed]
[41] Zhang, Y., Wang, X., Shan, M., Lu, Q. and Tian, T. (2025) Efficacy of Transcervical Resection of Polyp Combined with Levonorgestrel-Releasing Intrauterine System in the Treatment of Endometrial Polyps: A Randomized Controlled Trial. Minimally Invasive Therapy & Allied Technologies, 35, 34-42. [Google Scholar] [CrossRef
[42] Bougie, O., Randle, E., Thurston, J., Magee, B., Warshafsky, C. and Rittenberg, D. (2024) Guideline No. 447: Diagnosis and Management of Endometrial Polyps. Journal of Obstetrics and Gynaecology Canada, 46, Article ID: 102402. [Google Scholar] [CrossRef] [PubMed]
[43] Wang, M., Gao, F., Zhang, H. and Zheng, W. (2025) Endometrial Polyps with Bizarre Stromal Cells: A Benign or a Low-Grade Lesion? BMC Womens Health, 25, Article No. 51. [Google Scholar] [CrossRef] [PubMed]
[44] Zhou, Q., Cui, H., Han, W. and Huang, J. (2025) Presentation of Endometrial Vascular Dystrophy under Narrow-Band Imaging: Two Case Reports and Literature Review. Medicine, 104, e41807. [Google Scholar] [CrossRef] [PubMed]
[45] Hosseini, S., Abbasi, H., Salehpour, S., Saharkhiz, N. and Nemati, M. (2024) Prevalence of Chronic Endometritis in Infertile Women Undergoing Hysteroscopy and Its Association with Intrauterine Abnormalities: A Cross-Sectional Study. JBRA Assisted Reproduction, 28, 430-434. [Google Scholar] [CrossRef] [PubMed]
[46] Byeon, H. (2024) Timely Identification and Treatment of Uterine Artery Pseudoaneurysm after Hysteroscopic Procedures. World Journal of Gastrointestinal Oncology, 16, 4762-4765. [Google Scholar] [CrossRef] [PubMed]
[47] Gaddam, T.R. and Chakravarthi, K.K. (2025) Surgical Intervention of Huge Uterine Polyp and Its Oncogenic Potential and Clinical Implications. Annals of African Medicine, 25, 252-256. [Google Scholar] [CrossRef] [PubMed]
[48] Kuroda, K., Yamanaka, A., Takamizawa, S., Nakao, K., Kuribayashi, Y., Nakagawa, K., et al. (2022) Prevalence of and Risk Factors for Chronic Endometritis in Patients with Intrauterine Disorders after Hysteroscopic Surgery. Fertility and Sterility, 118, 568-575. [Google Scholar] [CrossRef] [PubMed]
[49] Elliot, D.L., Tolle, S.W. and Linz, D.H. (1985) Preparing the Medically Compromised Patient for Surgery. Postgraduate Medicine, 77, 269-282. [Google Scholar] [CrossRef] [PubMed]
[50] Rodríguez-Gómez, J., Mompó, B., Gredilla, E., López, M.A. and Gilsanz, F. (2012) Hemorragia obstétrica masiva en una paciente con placenta pércreta. Revista Española de Anestesiología y Reanimación, 59, 452-455. [Google Scholar] [CrossRef] [PubMed]
[51] Advincula, A.P. and Wang, K. (2009) Evolving Role and Current State of Robotics in Minimally Invasive Gynecologic Surgery. Journal of Minimally Invasive Gynecology, 16, 291-301. [Google Scholar] [CrossRef] [PubMed]
[52] Ansari, S.H., Bigatti, G. and Aghssa, M.M. (2018) Operative Hysteroscopy with the Bigatti Shaver (IBS ®) for the Removal of Placental Remnants. Facts, Views and Vision in ObGyn, 10, 153-159.
[53] Wang, Y. and Li, R. (2024) [Call Attention to the Reproductive Disorders of Chronic Endometritis]. National Medical Journal of China, 104, 3631-3635.
[54] Chiofalo, B., Calandra, M., Bruno, V., Tarantino, V., Esposito, G., Vizza, E., et al. (2023) Outpatient Hysteroscopic Polypectomy—A Retrospective Study Comparing Rigid and Semirigid Office Hysteroscopes. Diagnostics, 13, Article 988. [Google Scholar] [CrossRef] [PubMed]