Comparative effectiveness research of hysteroscopic combined with laparoscopic muscle flap filling suture and hysteroscopic electrotomy in the treatment of uterine scar diverticulum
Comparative effectiveness research of hysteroscopic combined with laparoscopic muscle flap filling suture and hysteroscopic electrotomy in the treatment of uterine scar diverticulum
Objective:To investigate the clinical effectiveness of hysteroscopic electrotomy and hysteroscopic combined with laparoscopic muscle flap filling suture in the treatment of uterine scar diverticulum.Methods:Retrospective analysis was made on the clinical data of 68 patients with uterine scar diverticulum who underwent surgical treatment from Aug.2018 to Jun.2023.They were divided into 2 groups according to the surgical method.Group A(n=38)underwent hysteroscopic electrotomy,group B(n=30)under-went hysteroscopic combined with laparoscopic muscle flap filling suture.The surgical parameters,clinical efficacy,and anterior uterine wall thickness 3 months after operation were compared between the two groups.Results:The menstrual period of two groups significantly shortened,and were statistically significant before and after surgery(P<0.05);intraoperative blood loss,operation time and hospital stay of group A were less than those of group B(P<0.05).Three months after surgery,there was no significant change in muscle layer thickness at front wall of uterine lower extreme before and after surgery in group A.After surgery the thickness of the uterine muscle layer in group B significantly increased from(2.09±0.48)mm to(6.52±0.21)mm(P<0.05).Conclusions:Both the hysteroscopic electrotomy and hysteroscopic combined with laparoscopic muscle flap filling suture can significantly improve the abnormal uterine bleeding symptoms caused by uterine scar diverticulum after cesarean section.Hysteroscopic electrotomy is relatively simple,with few trauma and intraoperative blood loss,and short operation time.This method is suitable for patients with no fertility intention,prolonged menstrual periods affecting the quality of life,and residual uterine muscle layer thickness at diverticulum≥3 mm.Hysteroscopic combined with laparoscopic muscle flap filling suture does not destroy the integrity of the uterus.The postoperative contraceptive time is short.It can increase the muscle layer thickness of uterine front wall,is the preferred surgery for uterine diverticulum patients with ferti-lity requirements.
关键词
子宫瘢痕憩室/电切术/肌瓣填充术/宫腔镜检查/腹腔镜检查/疗效比较研究
Key words
Cervical scar diverticulum/Electrocautery/Myometrial flap filling/Hysteroscopy/Laparoscopy/Comparative effec-tiveness research
维普
万方数据