{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,22]],"date-time":"2025-11-22T15:31:04Z","timestamp":1763825464425,"version":"3.45.0"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T00:00:00Z","timestamp":1750204800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp;amp; Obste"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare surgical and oncologic outcomes between conventional resectoscopic surgery and mechanical hysteroscopic tissue removal (mHTR) systems in high\u2010risk patients not suitable for standard surgery undergoing conservative treatment for multifocal endometrial atypical hyperplasia\/endometrial intraepithelial neoplasia (EAH\/EIN) or early\u2010stage low\u2010grade endometrioid endometrial cancer (EEC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a single\u2010center, retrospective cohort study at the Department of Gynecology and Physiopathology of Human Reproduction, S. Orsola\u2010Malpighi Hospital, University of Bologna, Italy. A total of 31 high\u2010surgical\u2010risk patients with EAH\/EIN or early\u2010stage low\u2010grade EEC were included: 18 underwent conventional resectoscopic endo\u2010myometrial resection, while 13 were treated with mHTR systems. All patients received a levonorgestrel\u2010releasing intrauterine device (LNG\u2010IUD) postoperatively. After treatment, patients underwent an 18\u2010month follow up with endometrial biopsies every 6\u2009months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mHTR group had significantly shorter operative times (mean 12.3\u2009\u00b1\u20097.7\u2009min) compared with the resectoscopic surgery group (mean 40.6\u2009\u00b1\u200911.8\u2009min,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Additionally, the incidence of intrauterine adhesions was lower in the mHTR group (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). There were no significant differences between the two groups in terms of disease presence at 6, 12, or 18\u2009months.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Hysteroscopic endo\u2010myometrial resection, with resectoscopic technique or with mHTR systems, combined with LNG\u2010IUD may represent a safe alternative for patients at high surgical risk with EAH\/EIN or early\u2010stage low\u2010grade EEC. Moreover, mHTR demonstrated advantages such as shorter operative times and fewer adhesions. A large multicenter prospective study is needed to confirm our study findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70320","type":"journal-article","created":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T08:20:42Z","timestamp":1750234842000},"page":"1371-1377","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Conservative hysteroscopic treatment of endometrial intraepithelial neoplasia and endometrial cancer in patients with high surgical risk with mechanical hysteroscopic tissue removal systems: A retrospective cohort study"],"prefix":"10.1002","volume":"171","author":[{"given":"Alessandro","family":"Arena","sequence":"first","affiliation":[{"name":"Division of Gynecology and Human Reproduction Physiopathology IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"},{"name":"Department of Medical and Surgical Sciences DIMEC, University of Bologna  Bologna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Camilla","family":"Franceschini","sequence":"additional","affiliation":[{"name":"Department of Gynecological and Obstetrics San Luca Hospital  Lucca Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9625-7496","authenticated-orcid":false,"given":"Eugenia","family":"Mantovani","sequence":"additional","affiliation":[{"name":"Division of Gynecology and Human Reproduction Physiopathology IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"},{"name":"Department of Medical and Surgical Sciences DIMEC, University of Bologna  Bologna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agnese","family":"Virgilio","sequence":"additional","affiliation":[{"name":"IRCCS Humanitas Research Hospital  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erika","family":"Bettiol","sequence":"additional","affiliation":[{"name":"Division of Gynecology and Human Reproduction Physiopathology IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"},{"name":"Department of Medical and Surgical Sciences DIMEC, University of Bologna  Bologna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuela","family":"Guerrini","sequence":"additional","affiliation":[{"name":"Division of Gynecology and Human Reproduction Physiopathology IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Attilio","family":"di Spiezio Sardo","sequence":"additional","affiliation":[{"name":"IRCCS Humanitas Research Hospital  Milan Italy"},{"name":"Departement of Public Health University of Naples Federico II  Naples 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University of Bologna  Bologna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,6,18]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"issue":"4","key":"e_1_2_8_3_1","first-page":"405","article-title":"Conservative treatment in early stage endometrial cancer: a review","volume":"90","author":"Trojano G","year":"2019","journal-title":"Acta Bio Med Atenei 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