Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, Massachusetts.
Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Massachusetts.
Fertil Steril. 2020 Apr;113(4):717-722. doi: 10.1016/j.fertnstert.2020.02.007. Epub 2020 Mar 5.
Laparoscopic abdominal cerclage is emerging as the preferred treatment option for patients with refractory cervical insufficiency. Laparoscopic abdominal cerclage reduces second-trimester loss and preterm birth with success rates similar to open abdominal cerclage. Increasing evidence also suggests improved neonatal survival rates with abdominal cerclage compared with repeat vaginal cerclage in patients who delivered prematurely despite a vaginal cerclage. The option to perform a highly effective treatment using minimally invasive techniques suggests laparoscopic abdominal cerclage will become the standard of care for refractory cervical insufficiency. This review examines the literature with regard to the indications and outcomes of abdominal cerclage, highlighting the laparoscopic technique.
腹腔镜腹部环扎术作为难治性宫颈机能不全患者的首选治疗方法正在兴起。腹腔镜腹部环扎术可降低中孕期流产和早产的风险，成功率与开放式腹部环扎术相似。越来越多的证据还表明，与重复阴道环扎术相比，对于尽管进行了阴道环扎术但仍早产的患者，腹部环扎术可提高新生儿存活率。使用微创技术进行高度有效的治疗的选择表明，腹腔镜腹部环扎术将成为难治性宫颈机能不全的标准治疗方法。本文综述了腹部环扎术的适应证和结局的文献，重点介绍了腹腔镜技术。
