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| Comparison of the effect of transvaginal debridement and incision diverticulum repair of pregnant lesions, and laparoscopic surgery for treating women with cesarean scars pregnancy |
| 1.Ya'an People's Hospital, Ya'an, Sichuan Province, 625000; 2.The Fifth People's Hospital of Chengdu |
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Abstract To analyze the effect of transvaginal debridement and incision diverticulum repair of pregnant lesions, and laparoscopic surgery for treating women with cesarean scars pregnancy (CSP). Method: The clinical data of 180 women with CSP from October 2014 to October 2017 were analyzed retrospectively, and these women were divided into group A (92 women with transvaginal debridement and incision diverticulum repair of pregnant lesions) and group B (88 women with laparoscopic surgery for debridement and incision diverticulum repair of pregnant lesions) according to the different treatments. The operative indexes, the situations of diverticulum and menstrual improvement before and after treatment, and the rates of complications and recurrence of the women were compared between the two groups. Results: Postoperative vaginal bleeding time, intraoperative bleeding, operation time, and hospitalization time of the women in group B were significant better than those of the women in group A. The diverticulum depth and diverticulum width of the women in both groups had decreased significantly, and the menstrual period of the women in both groups had shortened significantly (P＜0.05), but which all of the women after treatment had no significant differences between the two groups (P＞0.05). There was no significant difference in pregnancy rate (51.1% vs.51.1%) of the women within 2 years after operation between the two groups (P=0.995). The intrauterine pregnancy rate of the women in group A was significant higher than that of the women in group B (P＜0.05). There were no significant differences in the rates of scar pregnancy, diverticular pregnancy, and secondary infertility of the women between the two groups. There was no significant difference in the complication rate (4.4% vs.5.7%) of the women between the two groups (P=0.681). Conclusion: Both transvaginal pregnancy lesion debridement and incision diverticulum repair and laparoscopic surgery for treating CSP have good curative treatment. So in order to achieve the best therapeutic effect, appropriate surgical methods should be selected according to the specific situation in clinical practice.
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