Clinical study of gynecological endoscopic surgery in the combined treatment of previous cesarean scar diverticulum / 中国医师杂志

ABSTRACT

Objective To investigate the clinical value of hysteroscopy and combined laparoscopic surgery in the treatment of previous cesarean scar diverticulum (PCSD).Methods 36 cases of PCSD in our hospital from January 2013 to January 2015 were selected.Among them,13 cases were treated with hysteroscopy diverticulum incision (hysteroscopic surgery group),and 23 cases underwent hysteroscopy combined with laparoscopy diverticulectomy repair (combined operation group).The diagnosis and surgical treatment of PCSD patients were recorded and the pregnancy outcome was followed up.Results The operation time [(39.5 ± 17.1) min vs (92.3 ± 30.8) min],the amount of bleeding [(18.2 ± 5.6) ml vs (98.6 ± 24.4) ml] and the length of hospital stay [(2.3 ± 0.6) days vs (5.2 ± 1.1) days] in hysteroscopic surgery group were less than those of hysteroscopy combined with laparoscopy (P ＜ 0.05).The time of vaginal bleeding after operation [(6.3 ± 1.7) days vs (13.4 ± 2.7) days] & [(6.9 ± 2.2) days vs (14.0 ± 3.1) days] was significandy less than that before operation in two operation methods (P ＜ 0.05).8 cases effective,1 cases partially effective,3 cases invalid were in the hysteroscopy group,while 16 cases effective,5 cases partially effective,2 cases invalid were in the combined operation group.The difference of curative effect between the two surgical methods was not statistically significant (P ＞0.05).17 cases of fertility requiring patients underwent hysteroscopy combined with laparoscopy diverticulectomy repair,of which 8 eases were successfully delivered after operation.Conclusions Individualized clinical decision-making should be made for PCSD patients.Hysteroscopy and combined hysteroperitoneal surgery have the same effect,but the latter should be chosen for those with severe clinical symptoms or reproductive needs.