ABSTRACT
Objective To probe into the safety and feasibility of vaginal delivery of scar uterus in pregnancy. Methods 2048 cases of secondary pregnancy women in cesarean section in our hospital from Jan. 1 to Nov. 15, 2017, were selected, 1 case of women was randomly selected from each 15 cases as the sample in this study according to the inclusion criteria. A total of 136 cases were randomly allocated to 68 cases in the observation group and 68 cases in the control group. The observation group was treated with vaginal delivery again, while the control group was treated with cesarean section again. Then, the delivery situation, the amount of blood in the process of labor, the length of the hospitalization time, the Apgar score of the newborn and the puerperal infection of two groups of patients were observed, and the results of the indicators between the two groups were compared and analyzed. Results In the observation group, 63 cases of vaginal delivery were successful(92. 64％), and 5 cases (7. 36％) were failed. In the control group, 68 cases (100％) were successful in cesarean section again, and there was no significant difference between the two groups (P＞0. 05). There was a statistically significant difference in the amount of blood produced during labor, neonatal Apgar score and puerperal infection between the two groups(P＜0. 05). There was no significant difference in hospitalization days (P＞0. 05). Conclusion It is safe and feasible for the clinical scar uterus to be pregnant through vaginal delivery.
ABSTRACT
PURPOSE: After the final report of Clinical Outcomes of Surgical Therapy (COST) study group, the application of laparoscopic surgery in colon cancer a spread widely. However, laparoscopic surgery in the rectum is still regarded as a complicated procedure to start due to technical difficulties and a steep learning curve. The aim of this study was to show the safety and technical feasibility of a laparoscopic low anterior resection at an early time on the learning curve in comparison with open low anterior resection. METHODS: The learning curves of one colorectal surgeon in open and laparoscopic low anterior resections were retrospectively compared. The compared factors were clinicopathologic characteristics, operation time, and the factors associated with postoperative recovery, morbidity and mortality. RESULTS: There were no significant differences in age or sex between two groups. The operation time was significantly longer in the laparoscopy group (P<0.001) In the view point of postoperative recovery, the laparoscopy group showed significant advantages in hospital stay (P<0.001), the passage of flatus (P<0.001), the number of analgesics used (P=0.03), and the removal of foley catheter (P=0.001). There were no conversions in the laparoscopy group, and the complication rate was lower in the laparoscopy group (10.7% vs. 17.6%). There was no postoperative mortality in either group. CONCLUSIONS: Even though the operation time was significantly longer in the laparoscopy group, a laparoscopic low anterior resection appears to have some benefits in postoperative recovery and morbidity. In terms of surgical outcomes, a laparoscopic low anterior resection can be performed safely even in early times on the learning curve.