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ORIGINAL ARTICLE   

Minerva Surgery 2022 April;77(2):139-46

DOI: 10.23736/S2724-5691.21.08999-1

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

An analysis of curative effect of combined transvaginal and hysteroscopic electrocauterization of partial endometrium to treat previous cesarean scar diverticulum

Li DAI 1, Hui WANG 1, Xiaoxiao XING 2, Yan PENG 3, Qing WANG 1, Qin LI 1, Dan LUO 1, Hongyan GAO 1 , Guohua JIANG 1

1 Department of Gynecology and Obstetrics, The Third Affiliated Hospital of Soochow University, Changzhou, China; 2 Department of Medical Imaging, The Third Affiliated Hospital of Soochow University, Changzhou, China; 3 Department of Pathology, The Third Affiliated Hospital of Soochow University, Changzhou, China



BACKGROUND: To explore the curative effect of the combined transvaginal and hysteroscopic electrocauterization of partial endometrium to treat previous cesarean scar diverticulum.
METHODS: The retrospective study method is adopted. 28 cases of cesarean scar diverticulum patients were selected as research objects and divided into two groups: one is combined hysteroscopic and transvaginal surgery group (N.=15) and the other is hysteroscopic electrocauterization group (N.=13). The curative effects of the two groups are observed and compared, including clinical treatment indicators (operation duration, intraoperative blood loss, fever, length of hospital stay (LOS), etc.), and follow-up visits are carried out to check the differences of diverticulum repair and menostaxis improvement one to six months after surgery.
RESULTS: The average operation duration, length of stay, and hospitalization expenses for the hysteroscopic electrocauterization group are 28.84±12.61 min, 2.93±1.04 days, and 7916.57±1948.45 yuan, respectively, all significantly lower than the combined hysteroscopic and transvaginal surgery group, those are respectively 73.93±15.46 min, 5.93±1.22 days, and 10,130.10±1037.75 yuan. The differences are statistically significant (P<0.05). The follow-up visits in six months after operation find that the effective rate of menstrual period (menostaxis) improvement of the combined hysteroscopic and transvaginal surgery group is 93.3% (14/15), and that of scar diverticulum repair is 73.3% (11/15), which are notably higher than the hysteroscopic electrocauterization group, those are respectively 46.2% (6/13) and 23.1% (3/13). The differences are also statistically significant (P<0.05).
CONCLUSIONS: The repairing effect of the combined transvaginal and hysteroscopic electrocauterization of partial endometrium to treat previous cesarean scar diverticulum [previous cesarean scar defect (PCSD)] is obvious. As it can fully remove previous cesarean scars and the surrounding ectopic intimae and reduce the recurrence rate, it is worthy of clinical promotion and application.


KEY WORDS: Hysteroscopy; Electrocoagulation; Endometrium; Diverticulum

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