Stark Michael, Mynbaev Ospan, Vassilevski Yuri, Rozenberg Patrick
The New European Surgical Society (NESA), Berlin, Germany; ELSAN Hospital Group, Paris, France.
N.I.Pirogov Russian National Research Medical University, Moscow, Russian Federation; Moscow Institute of Physics and Technology (MIPT) (State University), Dolgoprudny, Russian Federation.
AJP Rep. 2016 Jul;6(3):e352-e354. doi: 10.1055/s-0036-1593444.
Until today, there is no standardized Cesarean Section method and many variations exist. The main variations concern the type of abdominal incision, usage of abdominal packs, suturing the uterus in one or two layers, and suturing the peritoneal layers or leaving them open. One of the questions is the optimal location of opening the uterus. Recently, omission of the bladder flap was recommended. The anatomy and histology as results from the embryological knowledge might help to solve this question. The working thesis is that the higher the incision is done, the more damage to muscle tissue can take place contrary to incision in the lower segment, where fibrous tissue prevails. In this perspective, a call for participation in a two-armed prospective study is included, which could result in an optimal, evidence-based Cesarean Section for universal use.
直到今天,还没有标准化的剖宫产方法,存在许多变体。主要变体涉及腹部切口的类型、腹部敷料的使用、子宫单层或双层缝合,以及腹膜层的缝合或敞开。问题之一是子宫切开的最佳位置。最近,有人建议省略膀胱反折。胚胎学知识所带来的解剖学和组织学可能有助于解决这个问题。研究假设是,与下段切口(下段以纤维组织为主)相反,切口位置越高,对肌肉组织的损伤可能越大。从这个角度来看,本文呼吁参与一项双臂前瞻性研究,该研究可能会产生一种普遍适用的、基于证据的最佳剖宫产方法。