Evaluation of the efficacy of laparoscopic resection for the management of exogenous cesarean scar pregnancy

Capsule:
Laparoscopic resection of a cesarean scar pregnancy has the advantages of shorter procedure duration, less blood loss, a shorter hospital stay, and faster recovery.

Authors:
Guangwei Wang, M.M., Liu Xiaofei, M.M., Bi Fangfang, M.M., Lili Yin, M.M., Rina Sa, M.M., Dandan Wang, M.M., Qing Yang, M.D.

Volume 101, Issue 5, Pages 1501–1507

Abstract:

Objective:
To retrospectively analyze the clinical data of 71 patients with exogenous cesarean scar pregnancy (CSP) treated in our hospital in the past 2 years, to compare the outcomes of exogenous CSP treated with different methods, and to evaluate the safety and feasibility of laparoscopic resection of exogenous CSP.

Design:
Comparative observational study.

Setting:
Tertiary medical centers.

Patient(s):
71 women with exogenous cesarean scar pregnancy.

Intervention(s):
Hysteroscopic resection of CSP, and laparoscopic resection of CSP.

Main Outcome Measure(s):
Operation time, intraoperative blood loss, postoperative drainage of the uterine cavity, postoperative days in hospital, time for β-human chorionic gonadotropin (β-hCG) to return to normal levels, absorption time of the mass.

Result(s):
For the laparoscopic group, the time for serum β-hCG to return normal levels and the postoperative drainage of the uterine cavity were significantly lower than in the patients who had undergone hysteroscopic resection. We found no statistically significant difference in the intraoperative blood loss and postoperative days in hospital between the two groups, but the operation time was longer in laparoscopic group.

Conclusion(s):
Laparoscopic surgery for a cesarean scar pregnancy has the advantages of a high success rate, fewer complications, and a shorter time for β-hCG levels to normalize. This procedure is especially suitable for the treatment of exogenous CSP.

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