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Single-port laparoscopy-assisted vaginal repair of a cesarean scar defect: a single-center retrospective study

BACKGROUND: The incidence of uterine cesarean scar defect (niche) is high, and some patients require surgery. Single-port laparoscopy can reduce post-operative pain, and provide better cosmetic effects. This study was performed to evaluate the safety and superiority of single-port laparoscopy-assist...

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Autores principales: Zhang, Yong-Li, Wang, Guo-Cheng, Qu, Jun-Jie, Du, Gui-Qiang, Zhou, Wei-Qiang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7004616/
https://www.ncbi.nlm.nih.gov/pubmed/31929361
http://dx.doi.org/10.1097/CM9.0000000000000622
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author Zhang, Yong-Li
Wang, Guo-Cheng
Qu, Jun-Jie
Du, Gui-Qiang
Zhou, Wei-Qiang
author_facet Zhang, Yong-Li
Wang, Guo-Cheng
Qu, Jun-Jie
Du, Gui-Qiang
Zhou, Wei-Qiang
author_sort Zhang, Yong-Li
collection PubMed
description BACKGROUND: The incidence of uterine cesarean scar defect (niche) is high, and some patients require surgery. Single-port laparoscopy can reduce post-operative pain, and provide better cosmetic effects. This study was performed to evaluate the safety and superiority of single-port laparoscopy-assisted vaginal repair of uterine cesarean scar defect (niche) in women after cesarean section. METHODS: This study included 74 patients who were diagnosed with uterine cesarean niche at the Shanghai First Maternity and Infant Hospital from January 2013 to June 2015. Thirty-seven patients underwent single-port laparoscopy-assisted vaginal surgery as the case group, and the remaining patients underwent vaginal repair surgery as the control group. We collected data from the inpatient and follow-up medical records. The clinical characteristics of these two groups were compared. The odds ratios and 95% confidential intervals were calculated for each variable by univariate and multivariate analyses. RESULTS: Patients who underwent single-port laparoscopy-assisted vaginal repair had a significantly longer operation time (2.3 [2.0–2.7] vs. 2.0 [1.6–2.3] h, P = 0.015), shorter gas passage time (1.2 [1.0–1.5] vs. 1.7 [1.0–2.0] days, P = 0.012), shorter hospital stay (3.1 [3.0–4.0] vs. 4.5 [4.0–6.0] days, P = 0.019), and fewer complications (0 vs. 4 cases). Univariate analysis showed that depth of the niche (P = 0.021) the mild adhesiolysis score (P = 0.035) and moderate adhesiolysis score (P = 0.013) were associated with the bladder injury. Multivariate analysis showed that the moderate adhesiolysis score (P = 0.029; 95% confidence interval, 1.318–3.526) was the strongest independent predictor of bladder injury. CONCLUSION: This study confirmed the safety and superiority of single-port laparoscopy-assisted vaginal repair of uterine cesarean scars.
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spelling pubmed-70046162020-02-11 Single-port laparoscopy-assisted vaginal repair of a cesarean scar defect: a single-center retrospective study Zhang, Yong-Li Wang, Guo-Cheng Qu, Jun-Jie Du, Gui-Qiang Zhou, Wei-Qiang Chin Med J (Engl) Original Articles BACKGROUND: The incidence of uterine cesarean scar defect (niche) is high, and some patients require surgery. Single-port laparoscopy can reduce post-operative pain, and provide better cosmetic effects. This study was performed to evaluate the safety and superiority of single-port laparoscopy-assisted vaginal repair of uterine cesarean scar defect (niche) in women after cesarean section. METHODS: This study included 74 patients who were diagnosed with uterine cesarean niche at the Shanghai First Maternity and Infant Hospital from January 2013 to June 2015. Thirty-seven patients underwent single-port laparoscopy-assisted vaginal surgery as the case group, and the remaining patients underwent vaginal repair surgery as the control group. We collected data from the inpatient and follow-up medical records. The clinical characteristics of these two groups were compared. The odds ratios and 95% confidential intervals were calculated for each variable by univariate and multivariate analyses. RESULTS: Patients who underwent single-port laparoscopy-assisted vaginal repair had a significantly longer operation time (2.3 [2.0–2.7] vs. 2.0 [1.6–2.3] h, P = 0.015), shorter gas passage time (1.2 [1.0–1.5] vs. 1.7 [1.0–2.0] days, P = 0.012), shorter hospital stay (3.1 [3.0–4.0] vs. 4.5 [4.0–6.0] days, P = 0.019), and fewer complications (0 vs. 4 cases). Univariate analysis showed that depth of the niche (P = 0.021) the mild adhesiolysis score (P = 0.035) and moderate adhesiolysis score (P = 0.013) were associated with the bladder injury. Multivariate analysis showed that the moderate adhesiolysis score (P = 0.029; 95% confidence interval, 1.318–3.526) was the strongest independent predictor of bladder injury. CONCLUSION: This study confirmed the safety and superiority of single-port laparoscopy-assisted vaginal repair of uterine cesarean scars. Wolters Kluwer Health 2020-02-05 2020-02-05 /pmc/articles/PMC7004616/ /pubmed/31929361 http://dx.doi.org/10.1097/CM9.0000000000000622 Text en Copyright © 2020 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0
spellingShingle Original Articles
Zhang, Yong-Li
Wang, Guo-Cheng
Qu, Jun-Jie
Du, Gui-Qiang
Zhou, Wei-Qiang
Single-port laparoscopy-assisted vaginal repair of a cesarean scar defect: a single-center retrospective study
title Single-port laparoscopy-assisted vaginal repair of a cesarean scar defect: a single-center retrospective study
title_full Single-port laparoscopy-assisted vaginal repair of a cesarean scar defect: a single-center retrospective study
title_fullStr Single-port laparoscopy-assisted vaginal repair of a cesarean scar defect: a single-center retrospective study
title_full_unstemmed Single-port laparoscopy-assisted vaginal repair of a cesarean scar defect: a single-center retrospective study
title_short Single-port laparoscopy-assisted vaginal repair of a cesarean scar defect: a single-center retrospective study
title_sort single-port laparoscopy-assisted vaginal repair of a cesarean scar defect: a single-center retrospective study
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7004616/
https://www.ncbi.nlm.nih.gov/pubmed/31929361
http://dx.doi.org/10.1097/CM9.0000000000000622
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