Nather A, Zeisler H, Sam C E, Husslein P, Joura E A
Universitätsklinik für Frauenheilkunde Wien, Allgemeines Krankenhaus (AKH), Wien, Osterreich.
Wien Klin Wochenschr. 2001 Jun 15;113(11-12):451-3.
A number of publications advocate the short-term advantages of peritoneal nonclosure at cesarean section. However, currently there are no hard data available about long-term results and the repeat cesareans.
The study group of this retrospective analysis consisted of 30 women who underwent a repeat cesarean delivery, after a previous cesarean without closure of the visceral and parietal peritoneum. The control group (n = 31) had undergone peritoneal closure at the primary operation. All cesareans were performed at the same institution between 04/01/1997 and 12/31/1998 (first operation), and 01/01/1999 and 06/30/2000 (repeat operation).
The mean operation time was 38.9 (+/- 11.6) minutes in the study group and 44.2 (+/- 13.6) minutes in controls (p = 0.05). The mean incision-delivery time was 6.7 (+/- 3.2) minutes in the study group and 9.1 (+/- 3.9) minutes in controls (p < 0.01). No difference in intraoperative blood loss was observed between the two groups. In each cohort one case with significant intraabdominal adhesions was observed.
Our results indicate that nonclosure of the peritoneum at primary cesarean section does not promote intraabdominal adhesions. This appears to be beneficial for the repeat cesareans.
许多出版物都提倡剖宫产时不缝合腹膜的短期优势。然而，目前尚无关于长期结果和再次剖宫产的确凿数据。
本回顾性分析的研究组由30名女性组成，她们在先前剖宫产时未缝合脏腹膜和壁腹膜，此次接受再次剖宫产。对照组（n = 31）在初次手术时进行了腹膜缝合。所有剖宫产均于1997年4月1日至1998年12月31日（初次手术）以及1999年1月1日至2000年6月30日（再次手术）在同一机构进行。
研究组的平均手术时间为38.9（±11.6）分钟，对照组为44.2（±13.6）分钟（p = 0.05）。研究组的平均切开至娩出时间为6.7（±3.2）分钟，对照组为9.1（±3.9）分钟（p < 0.01）。两组术中失血量无差异。每个队列中均观察到1例有明显腹腔粘连的病例。
我们的结果表明，初次剖宫产时不缝合腹膜不会促进腹腔粘连。这似乎对再次剖宫产有益。
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