腹内宫颈环扎术治疗复发性宫颈机能不全：腹腔镜手术还是剖腹手术？
Abdominal cerclage for the treatment of recurrent cervical insufficiency: laparoscopy or laparotomy?
作者信息
Carter James F, Soper David E, Goetzl Laura M, Van Dorsten J Peter
机构信息
Department of Obstetrics and Gynecology, College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA.
出版信息
Am J Obstet Gynecol. 2009 Jul;201(1):111.e1-4. doi: 10.1016/j.ajog.2009.05.033.
OBJECTIVE
The purpose of this study was to compare the efficacy of traditional abdominal cerclage (AC) with laparoscopic cerclage (LC).
STUDY DESIGN
Eligible women had at least 1 second trimester pregnancy loss due to cervical insufficiency, and had undergone at least 1 failed transvaginal cerclage. A prospective cohort of patients undergoing LC was compared with a historical control group of patients who had AC. A successful primary outcome was defined as delivery of a viable infant with neonatal survival.
RESULTS
We were able to evaluate 19 pregnancies following unique abdominal cerclage placement, 12 laparoscopic and 7 at the time of laparotomy. Nine of 12 (75%) undergoing LC and 5 of 7 (71%) pregnancies undergoing AC successfully delivered a viable infant (P = .63). LC during pregnancy was successful in 4 of 5 (80%) cases as compared to 3 of 5 (60%) cases with AC during pregnancy (P = 1.0).
CONCLUSION
Operative laparoscopy is a safe and effective alternative to laparotomy for the placement of abdominal cerclage.
目的
本研究旨在比较传统腹部宫颈环扎术（AC）与腹腔镜宫颈环扎术（LC）的疗效。
研究设计
符合条件的女性因宫颈机能不全至少有1次孕中期流产，且至少经历过1次经阴道宫颈环扎术失败。将接受LC的前瞻性队列患者与接受AC的历史对照组患者进行比较。成功的主要结局定义为分娩出存活的新生儿。
结果
我们能够评估19例在进行独特的腹部宫颈环扎术后的妊娠情况，其中12例为腹腔镜手术，7例为开腹手术时进行。接受LC的12例患者中有9例（75%），接受AC的7例妊娠中有5例（71%）成功分娩出存活的婴儿（P = 0.63）。孕期进行LC的5例患者中有4例（80%）成功，而孕期进行AC的5例患者中有3例（60%）成功（P = 1.0）。
结论
手术腹腔镜检查是开腹进行腹部宫颈环扎术的一种安全有效的替代方法。
Zotero 插件