经宫腔镜辅助腹腔镜手术成功治疗 2 型剖宫产瘢痕妊娠。
Type 2 Cesarean Scar Pregnancy Successfully Treated via Hysteroscopy-Assisted Laparoscopy.
机构信息
Department of Gynecology and Obstetrics, Women's Hospital, Zhejiang University School of Medicine, Zhejiang Province, China (Drs. Qi and Lv); Department of Gynecology and Obstetrics, Taizhou Hospital of Zhejiang Province, Affiliated with Wenzhou Medical University, Linhai, Zhejiang Province, China (Drs. Qi, Chai, Liu, Zheng, Zhu, and Chen).
Department of Gynecology and Obstetrics, Taizhou Hospital of Zhejiang Province, Affiliated with Wenzhou Medical University, Linhai, Zhejiang Province, China (Drs. Qi, Chai, Liu, Zheng, Zhu, and Chen).
出版信息
J Minim Invasive Gynecol. 2019 Nov-Dec;26(7):1273-1281. doi: 10.1016/j.jmig.2018.11.019. Epub 2018 Dec 17.
STUDY OBJECTIVE
To evaluate the efficacy of hysteroscopy-assisted laparoscopy as a treatment strategy for type 2 cesarean scar pregnancy at gestational age >8 weeks.
DESIGN
Retrospective case series (Canadian Task Force classification II-3).
SETTING
A tertiary hospital.
PATIENTS
Eight women with type 2 cesarean scar pregnancy at a gestational age >8 weeks.
INTERVENTIONS
All patients underwent hysteroscopy-assisted laparoscopic resection and isthmus repair of cesarean scar pregnancy.
MEASUREMENTS AND MAIN RESULTS
All patients underwent removal of the cesarean scar pregnancy and complete repair of the uterine scar defect. The median operative time was 123.0 minutes (range, 100-168 minutes), median blood loss was 65.0 mL (range, 20-100 mL), and median length of hospital stay was 9.1 days (range, 8-12 days). There were no adverse reactions. The mean time to serum β-human chorionic gonadotropin (β-HCG) resolution was 22.9 days (range, 14-30 days), and menstruation resumed after 9 to 15 days with serum β-HCG returning to nondetectable levels. There was no recurrence of cesarean scar pregnancy at long-term follow-up.
CONCLUSION
Hysteroscopy-assisted laparoscopy may be an effective treatment for patients with type 2 cesarean scar pregnancy at gestational age >8 weeks.
研究目的
评估宫腔镜辅助腹腔镜治疗 8 周以上妊娠的 2 型剖宫产瘢痕妊娠的疗效。
设计
回顾性病例系列（加拿大任务组分类 II-3）。
设置
一家三级医院。
患者
8 名 8 周以上妊娠的 2 型剖宫产瘢痕妊娠患者。
干预措施
所有患者均接受宫腔镜辅助腹腔镜剖宫产瘢痕妊娠切除和峡部修复。
测量和主要结果
所有患者均成功切除剖宫产瘢痕妊娠，并完全修复子宫瘢痕缺陷。中位手术时间为 123.0 分钟（范围 100-168 分钟），中位出血量为 65.0 毫升（范围 20-100 毫升），中位住院时间为 9.1 天（范围 8-12 天）。无不良反应。血清β-人绒毛膜促性腺激素（β-HCG）恢复正常的平均时间为 22.9 天（范围 14-30 天），9-15 天恢复月经，血清β-HCG 降至不可检测水平。长期随访中无剖宫产瘢痕妊娠复发。
结论
宫腔镜辅助腹腔镜治疗 8 周以上妊娠的 2 型剖宫产瘢痕妊娠可能是一种有效的治疗方法。
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