You can always write a VB.Net macro to do this; depending on how flexible you want.
For search and replace in the current document, you can use this simple script - ALT + F11 to start the macro editor and then leave. Insert this subsection into the new module:
Sub RegexReplace()
Dim regex As String = InputBox("Enter regex for text to find")
Dim replace As String = InputBox("Enter replacement pattern")
Dim selection As EnvDTE.TextSelection = DTE.ActiveDocument.Selection
Dim editPoint As EnvDTE.EditPoint
selection.StartOfDocument()
selection.EndOfDocument(True)
DTE.UndoContext.Open("Custom regex replace")
Try
Dim content As String = selection.Text
Dim result = System.Text.RegularExpressions.Regex.Replace(content, regex, replace)
selection.Delete()
selection.Collapse()
Dim ed As EditPoint = selection.TopPoint.CreateEditPoint()
ed.Insert(result)
Catch ex As Exception
Finally
DTE.UndoContext.Close()
DTE.StatusBar.Text = "Regex Find/Replace complete"
End Try
End Sub
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