宫、腹腔镜联合手术治疗剖宫产术后子宫瘢痕憩室

目的:探讨剖宫产术后子宫瘢痕憩室应用宫、腹腔镜联合手术治疗的临床效果。方法:选择经彩色多普勒超声诊断子宫瘢痕憩室,有手术指征的患者17例,在全麻下进行宫、腹腔镜联合手术,分离子宫膀胱反折腹膜,切除憩室病灶,重新缝合子宫肌层。结果:17例患者手术顺利,平均手术时间为69.2±28.7(35~110)min,术后临床症状消失,6个月后复查超声肌层连续,肌壁厚度为1.35±0.28(0.8~1.8)cm,与术前的肌壁厚度0.33±0.10(0.17~0.5)cm相比,差异有统计学意义(P0.05)。结论:宫、腹腔镜联合手术治疗剖宫产术后子宫瘢痕憩室安全,微创,效果确切。

Hysteroscopy Combined with Laparoscopy in Treatment of Cesarean Section Scar Diverticulum

Objective： To investigate the clinical effect of hysteroscopy combined with laparoscopy in treatment of cesarean section scar diverticulum. Methods： There were 17 patients diagnosed by the color Doppler ultrasound with uterine scar diverticulum, all had the operation indication. Hysteroscopy combined with laparoscopy operation was performed under general anesthesia. The bladder and uterus reflexed peritoneal lesions were seperated, the diverticulum was resected, and the uterine myometrium was restricted. Results： After operation, the postoperative clinical symptoms had disappeared. Average operation time was 69.2± 28.7 （35-110） min. The average muscle layer thickness was 1.35 ±0.28 （0.8-1.8） cm after 6 months of operation, and was significantly thicker than that of preoperative muscle layer [0.33 ±0.10 （0.2-0.5） cm]. Conclusion： Hysteroscopy combined with laparoscopy in treatment of cesarean section scar diverticulum was safe, minimally invasive and effective.