Clinical effects analysis of hysteroscopy and hysteroscopy combined with laparoscopy in repairing previous cesarean scar diverticulum

doi:10.3877/cma.j.issn.1673-5250.2017.03.017

Objective

To evaluate clinical effects of hysteroscopy and hysteroscopy combined with laparoscopy in repairing previous cesarean scar diverticulum (PCSD).

Methods

A total of 50 cases of patients who were diagnosed as PCSD through ultrasound or hysteroscopy and treated in Chengdu Women & Children′s Central Hospital from January 2011 to January 2016 were selected as research subjects. They were divided into hysteroscopy group (n=18, received hysteroscopic repair) and combined therapy group (n=32, received hysteroscopic repair combined with laparoscopic repair) according to the treatment methods. Intraoperative bleeding volume, operation duration, postoperative hospitalization time, complications, repair of PCSD and the improvement of menstrual period of two groups were retrospectively analyzed and compared by statistical methods. There were no statistical differences between two groups in the age, times of cesarean delivery, menstrual period and preoperative PCSD depth (P>0.05).

Results

①The intraoperative bleeding volume, operation duration and postoperative hospitalization time of hysteroscopy group all were better than those of combined therapy group, and all the differences were statistically significant (t=-6.606, -10.525, -10.437; P<0.001). ②All the 50 cases of PCSD patients were well recovered after surgery, and no complications related with repair surgery occurred. After 6 months of surgery, the menstruation period improvement rates were 88.9% (16/18) and 87.5% (28/32) in hysteroscopy group and combined therapy group, respectively, and the difference between the two groups had no statistical significance (χ²=0.021, P=0.885). The PCSD improvement rates were 94.4% (17/18) and 93.8% (30/32) in hysteroscopy group and combined therapy group, respectively, and the difference between the two groups had no statistical significance (χ²=0.010, P=0.921).

Conclusions

Both of hysteroscopy and hysteroscopy combined with laparoscopy have good effects in repairing PCSD and can markedly improve the clinical symptoms of patients. Different measures should be given to different PCSD patients according to the patients′ individual situations.

Key words: Hysteroscopy, Laparoscopy, Repair, Previous cesarean scar diverticulum, Female

表1 2组剖宫产术后子宫切口憩室患者术中出血量、手术时间、术后住院时间比较(±s)

组别	例数	术中出血量(mL)	手术时间(min)	术后住院时间(d)
宫腔镜组	18	14.7±4.1	23.6±6.9	3.1±0.5
联合治疗组	32	61.1±34.2	92.3±29.9	5.3±0.7
t值	?	－6.606	－10.525	－10.437
P值	?	<0.001	<0.001	<0.001

表1 2组剖宫产术后子宫切口憩室患者术中出血量、手术时间、术后住院时间比较(±s)

组别	例数	术中出血量(mL)	手术时间(min)	术后住院时间(d)
宫腔镜组	18	14.7±4.1	23.6±6.9	3.1±0.5
联合治疗组	32	61.1±34.2	92.3±29.9	5.3±0.7
t值	?	－6.606	－10.525	－10.437
P值	?	<0.001	<0.001	<0.001

表2 2组剖宫产术后子宫切口憩室患者修补术后月经期改善情况及剖宫产术后子宫切口憩室修复情况比较

组别	例数	术前月经期(d, ±s)	术后月经期(d，±s)	月经期改善有效率[例数(%)]	PCSD修复有效率[例数(%)]
宫腔镜组	18	13.7±1.8	7.7±2.6	16(88.9)	17(94.4)
联合治疗组	32	14.4±3.3	7.3±2.0	28(87.5)	30(93.8)
检验值	?	t＝0.807	t＝0.438	χ²＝0.021	χ²＝0.010
P值	?	0.458	0.534	0.885	0.921

表2 2组剖宫产术后子宫切口憩室患者修补术后月经期改善情况及剖宫产术后子宫切口憩室修复情况比较

组别	例数	术前月经期(d, ±s)	术后月经期(d，±s)	月经期改善有效率[例数(%)]	PCSD修复有效率[例数(%)]
宫腔镜组	18	13.7±1.8	7.7±2.6	16(88.9)	17(94.4)
联合治疗组	32	14.4±3.3	7.3±2.0	28(87.5)	30(93.8)
检验值	?	t＝0.807	t＝0.438	χ²＝0.021	χ²＝0.010
P值	?	0.458	0.534	0.885	0.921

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