Department of Minimally Invasive Gynecologic Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University (Drs. Y. Wang, Duan, and S. Wang).
Department of Minimally Invasive Gynecologic Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University (Drs. Y. Wang, Duan, and S. Wang).
J Minim Invasive Gynecol. 2020 Sep-Oct;27(6):1300-1307. doi: 10.1016/j.jmig.2019.09.774. Epub 2019 Oct 2.
To report on our center's experience of a novel modified approach for laparoscopic cervical cerclage and to evaluate its safety and efficacy preliminarily.
Retrospective descriptive study.
Single academic institution.
Pregnant and nonpregnant women who underwent the modified laparoscopic transabdominal cervical cerclage with transvaginal removing (MLTCC-TR) from June 2016 to April 2019. Eligible participants had multiple adverse obstetric histories or the short cervix and were not suitable for a second transvaginal cerclage.
Preconceptional or postconceptional MLTCC-TR.
A total of 24 participants (including 3 first-trimester singleton pregnant women) underwent the MLTCC-TR, giving birth to 27 infants. Among 21 women who underwent preconceptional cerclage, 26 cases of postoperational pregnancies were noted, and the incidence of term labor was 73.07%, which was significantly higher than that in the precerclage group (p <.001). Their mean gestational age at delivery was 37.21 ± 5.05 weeks. Among 3 cases of postconceptional cerclage, the mean gestational age at cerclage was 10.90 ± 2.61 weeks, and all of them had term delivery. The overall neonatal survival rate was 100% (27/27), of which 81.48% (22/27) were term infants. There were no severe perioperative complications directly related to the insertion of cerclage.
Our new approach of MLTCC-TR may be a relatively effective, feasible, and safe treatment for cervical insufficiency. It may be considered as an acceptable alternative to the traditional laparoscopic cervical cerclage with its superiority of transvaginal removing.
报告我们中心采用一种新的改良腹腔镜宫颈环扎术的经验，并初步评估其安全性和有效性。
回顾性描述性研究。
单家学术机构。
2016 年 6 月至 2019 年 4 月期间接受改良腹腔镜经腹宫颈环扎术联合经阴道取出术（MLTCC-TR）的妊娠和非妊娠妇女。纳入标准为存在多次不良产科病史或宫颈短，不适合再次行经阴道环扎术。
孕前或孕后 MLTCC-TR。
共 24 名患者（包括 3 例孕早期单胎妊娠妇女）接受了 MLTCC-TR，分娩 27 名婴儿。21 名接受孕前环扎术的妇女中，26 例术后妊娠，足月分娩率为 73.07%，明显高于术前（p <.001）。她们的平均分娩孕周为 37.21 ± 5.05 周。3 例孕后环扎者，环扎时的平均孕周为 10.90 ± 2.61 周，均足月分娩。总的新生儿存活率为 100%（27/27），其中 81.48%（22/27）为足月婴儿。无严重与环扎置入相关的围手术期并发症。
我们的 MLTCC-TR 新方法可能是治疗宫颈功能不全的一种相对有效、可行且安全的方法。与传统腹腔镜宫颈环扎术相比，它具有经阴道取出的优势，可作为一种可接受的替代方法。
