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Selection of Laparoscopy or Laparotomy for Treating Cesarean Scar Pregnancy: A Retrospective Study

OBJECTIVE: Cesarean scar pregnancy (CSP) can have catastrophic consequences, but a standardized diagnosis and treatment for CSP are lacking. At least 10 different treatments are currently available, further confusing treatment selection. The aim of this study was to compare the outcomes of using lap...

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Autores principales: Fu, Peiying, Zhou, Ting, Cui, Pengfei, Wang, Wenwen, Wang, Shixuan, Liu, Ronghua
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9482461/
https://www.ncbi.nlm.nih.gov/pubmed/36124106
http://dx.doi.org/10.2147/IJGM.S369884
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author Fu, Peiying
Zhou, Ting
Cui, Pengfei
Wang, Wenwen
Wang, Shixuan
Liu, Ronghua
author_facet Fu, Peiying
Zhou, Ting
Cui, Pengfei
Wang, Wenwen
Wang, Shixuan
Liu, Ronghua
author_sort Fu, Peiying
collection PubMed
description OBJECTIVE: Cesarean scar pregnancy (CSP) can have catastrophic consequences, but a standardized diagnosis and treatment for CSP are lacking. At least 10 different treatments are currently available, further confusing treatment selection. The aim of this study was to compare the outcomes of using laparotomy or laparoscopy to treat CSP. METHODS: We reviewed data from 935 patients with suspected CSP from 1 January 2013 to 31 December 2018. A total of 278 patients were included in the study, of whom 121 were treated with laparoscopy and 157 were treated with laparotomy. We compared and analyzed the characteristics of laparoscopic and open surgeries for treating CSP cases and the advantages and disadvantages of different vascular pretreatments. RESULTS: Intraoperative bleeding, the transfusion rate, total days of hospitalization and postoperative hospital length of stay were lower with laparoscopy than laparotomy (P < 0.05). There was no difference in the factors (beta human chorionic gonadotropin [β-HCG] decrease, reoperation rate and tissue residues) closely related to the success of the surgery in the two groups. Furthermore, we used different blood vessel pretreatments among patients. The rates of tissue residue, reoperation and intraoperative blood transfusion were lower in patients with temporary vascular occlusion than in patients with permanent vascular occlusion. CONCLUSION: This study revealed that laparoscopic surgery is superior to laparotomic surgery for treating CSP. Patients in both groups benefited from temporary arterial occlusion. Thus, temporary arterial occlusion with laparoscopic surgery may be the best treatment for CSP.
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spelling pubmed-94824612022-09-18 Selection of Laparoscopy or Laparotomy for Treating Cesarean Scar Pregnancy: A Retrospective Study Fu, Peiying Zhou, Ting Cui, Pengfei Wang, Wenwen Wang, Shixuan Liu, Ronghua Int J Gen Med Original Research OBJECTIVE: Cesarean scar pregnancy (CSP) can have catastrophic consequences, but a standardized diagnosis and treatment for CSP are lacking. At least 10 different treatments are currently available, further confusing treatment selection. The aim of this study was to compare the outcomes of using laparotomy or laparoscopy to treat CSP. METHODS: We reviewed data from 935 patients with suspected CSP from 1 January 2013 to 31 December 2018. A total of 278 patients were included in the study, of whom 121 were treated with laparoscopy and 157 were treated with laparotomy. We compared and analyzed the characteristics of laparoscopic and open surgeries for treating CSP cases and the advantages and disadvantages of different vascular pretreatments. RESULTS: Intraoperative bleeding, the transfusion rate, total days of hospitalization and postoperative hospital length of stay were lower with laparoscopy than laparotomy (P < 0.05). There was no difference in the factors (beta human chorionic gonadotropin [β-HCG] decrease, reoperation rate and tissue residues) closely related to the success of the surgery in the two groups. Furthermore, we used different blood vessel pretreatments among patients. The rates of tissue residue, reoperation and intraoperative blood transfusion were lower in patients with temporary vascular occlusion than in patients with permanent vascular occlusion. CONCLUSION: This study revealed that laparoscopic surgery is superior to laparotomic surgery for treating CSP. Patients in both groups benefited from temporary arterial occlusion. Thus, temporary arterial occlusion with laparoscopic surgery may be the best treatment for CSP. Dove 2022-09-13 /pmc/articles/PMC9482461/ /pubmed/36124106 http://dx.doi.org/10.2147/IJGM.S369884 Text en © 2022 Fu et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Fu, Peiying
Zhou, Ting
Cui, Pengfei
Wang, Wenwen
Wang, Shixuan
Liu, Ronghua
Selection of Laparoscopy or Laparotomy for Treating Cesarean Scar Pregnancy: A Retrospective Study
title Selection of Laparoscopy or Laparotomy for Treating Cesarean Scar Pregnancy: A Retrospective Study
title_full Selection of Laparoscopy or Laparotomy for Treating Cesarean Scar Pregnancy: A Retrospective Study
title_fullStr Selection of Laparoscopy or Laparotomy for Treating Cesarean Scar Pregnancy: A Retrospective Study
title_full_unstemmed Selection of Laparoscopy or Laparotomy for Treating Cesarean Scar Pregnancy: A Retrospective Study
title_short Selection of Laparoscopy or Laparotomy for Treating Cesarean Scar Pregnancy: A Retrospective Study
title_sort selection of laparoscopy or laparotomy for treating cesarean scar pregnancy: a retrospective study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9482461/
https://www.ncbi.nlm.nih.gov/pubmed/36124106
http://dx.doi.org/10.2147/IJGM.S369884
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