Takeda Jun, Kumakiri Jun, Makino Shintaro, Itakura Atsuo, Takeda Satoru
Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan.
Gynecol Minim Invasive Ther. 2017 Apr-Jun;6(2):73-75. doi: 10.1016/j.gmit.2016.03.002. Epub 2016 May 15.
Uterine compression suturing is a relatively easy and effective way of hemostasis during cesarean section and is becoming widely accepted. However, complications such as necrosis or synechiae have been reported. We firstly report a case of laparoscopic removal of vertical compression sutures and discuss its benefits and improvements to be made. This case report is of a 32-year-oId woman with placenta previa who received uterine vertical compression sutures for controlling massive bleeding during cesarean section. Because she complained of unbearable pelvic pain, laparoscopic compression suture removal was performed. Her pain was relieved after the threads were removed, suggesting that the compression sutures were the cause of her pelvic pain due to uterine ischemia. Although the risks of reoperation during the early postpartum period still exist, compression suture thread removal should be considered in cases of suspected uterine ischemia.
子宫压迫缝合术是剖宫产术中一种相对简单有效的止血方法,且正被广泛接受。然而,已有坏死或粘连等并发症的报道。我们首次报告了一例腹腔镜下取出垂直压迫缝线的病例,并讨论了其益处及有待改进之处。本病例报告的是一名32岁前置胎盘女性,她在剖宫产术中接受子宫垂直压迫缝合术以控制大量出血。由于她主诉盆腔疼痛难忍,遂行腹腔镜下压迫缝线取出术。缝线取出后她的疼痛缓解,提示压迫缝线是其因子宫缺血导致盆腔疼痛的原因。尽管产后早期再次手术的风险仍然存在,但对于疑似子宫缺血的病例,应考虑取出压迫缝合线。