Zhang Yanhua, Jia Yanfeng, Wang Xiaoli, Sun Qian
Department of Gynecology, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, China.
J Obstet Gynaecol Res. 2020 Sep;46(9):1758-1765. doi: 10.1111/jog.14351. Epub 2020 Jun 21.
This study analyses the effects of surgical indicators and clinical efficacy of different surgical methods for uterine cesarean section scar diverticulum.
This retrospective cohort study included 65 patients who underwent surgery and postoperative follow-up at Gansu Provincial Maternity and Child-care Hospital from 1 January 2013 to 31 February 2019.
All participants were treated surgically. Among them, patients in Group A underwent combined laparoscopic and hysteroscopic surgery (n = 45), Group B underwent transvaginal surgery (n = 11), Group C underwent laparotomy (n = 9). The primary outcomes were surgical indicators. The secondary outcomes were clinical efficacy. Bleeding, operation time and hospitalization expenses were significantly different among the three groups (P < 0.05). There was no difference in the hospital stay among the three groups P = 0.22). The menstrual period before and after surgery was significantly different among the groups (P < 0.05). The recurrence outcome was no significantly different (P = 0.16), but the pregnancy outcome was not (P = 0.78).
The three surgical methods are effective for treating cesarean section scar diverticulum with favorable effects. Laparoscopic combined with hysteroscopic surgery is minimally invasive with less bleeding compared with the other two techniques and it is easier for patients to accept. It is the most widely used surgical method.
本研究分析子宫剖宫产瘢痕憩室不同手术方法的手术指标及临床疗效。
本回顾性队列研究纳入了2013年1月1日至2019年2月28日在甘肃省妇幼保健院接受手术及术后随访的65例患者。
所有参与者均接受手术治疗。其中,A组患者接受腹腔镜联合宫腔镜手术(n = 45),B组接受经阴道手术(n = 11),C组接受开腹手术(n = 9)。主要结局为手术指标。次要结局为临床疗效。三组间出血、手术时间及住院费用差异有统计学意义(P < 0.05)。三组间住院时间差异无统计学意义(P = 0.22)。组间手术前后月经期差异有统计学意义(P < 0.05)。复发结局差异无统计学意义(P = 0.16),但妊娠结局差异无统计学意义(P = 0.78)。
三种手术方法治疗剖宫产瘢痕憩室均有效。与其他两种技术相比,腹腔镜联合宫腔镜手术创伤小、出血少,患者更容易接受。它是应用最广泛的手术方法。