既往剖宫产患者腹腔镜全子宫切除术的围术期及术后并发症。

IF 1.3 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Israel Medical Association Journal Pub Date : 2025-09-01
Yuval Gedalia, Yael Baumfeld, Reut Rotem, Moran Weiss, Neriya Yohay, Adi Y Weintraub
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引用次数: 0

摘要

背景:剖宫产(CS)占所有分娩的近三分之一。CS术后的并发症之一是腹腔和盆腔粘连的形成。目的:探讨腹腔镜子宫全切除术(TLH)时,既往CS是否会增加围手术期或术后并发症的风险。方法:我们对2014年至2020年间接受TLH的女性进行了回顾性队列研究。根据Clavien-Dindo分类系统评估围手术期和术后并发症。采用描述性统计方法对结果进行分析。结果:在研究期间,总共有190名妇女接受了TLH, 50名(26.5%)有既往CS(研究组),140名(73.5%)没有CS史。采用Clavien-Dindo分类系统,两组并发症发生率相似;然而,研究组的主要并发症发生率并未显著高于对照组(对照组为6%,对照组为1.4%,P = 0.08)。尿道损伤是最常见的主要并发症(2.4%比1.0.7%)。手术持续时间(125分钟对112分钟,P = 0.02),估计失血量(174 ml对115 ml, P = 0.02),以及术后额外的内镜干预(4%对0%,P = 0.01),在既往CS患者中显著增加。结论:尽管既往CS患者术后内镜干预的需要、手术时间和估计的出血量明显更高,但TLH仍然是这些患者的安全推荐手术。主要的并发症是罕见的,并且在先前的CS之后不会更频繁地发生。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Perioperative and Postoperative Complications During Total Laparoscopic Hysterectomy in Patients with a Previous Cesarean Section.

Background: Cesarean section (CS) comprised almost one-third of all births. One of the complications after CS is intra-abdominal and pelvic adhesions formation.

Objectives: To investigate whether a previous CS poses an additional perioperative or postoperative risk for complications when performing a total laparoscopic hysterectomy (TLH).

Methods: We conducted a retrospective cohort study of women who had undergone a TLH between 2014 and 2020. Perioperative and postoperative complications were assessed according to the Clavien-Dindo classification system. Descriptive statistics were used to analyze the results.

Results: In total, 190 women underwent TLH during the study period, 50 (26.5%) had a previous CS (study group) and 140 (73.5%) had no history of CS. The complication rates using the Clavien-Dindo classification system were similar in both groups; however, the major complications rate was not significantly higher in the study group (CS 6% vs. no CS 1.4%, P = 0.08). Urethral injury was the most common major complication (2, 4% vs. 1, 0.7%). The duration of surgery (125 min vs. 112 min, P = 0.02), estimated blood loss (174 ml vs. 115 ml, P = 0.02), and additional postoperative endoscopic interventions (4% vs. 0%, P = 0.01) and were significantly greater in patients with a previous CS.

Conclusions: Although the need for postoperative endoscopic interventions, surgery duration, and estimated blood loss were significantly higher in patients with a previous CS, TLH remains a safe and recommended procedure for these patients. Major complications are rare and do not occur more frequently following a previous CS.

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来源期刊
Israel Medical Association Journal
Israel Medical Association Journal 医学-医学:内科
CiteScore
2.20
自引率
12.50%
发文量
54
审稿时长
3-8 weeks
期刊介绍: The Israel Medical Association Journal (IMAJ), representing medical sciences and medicine in Israel, is published in English by the Israel Medical Association. The Israel Medical Association Journal (IMAJ) was initiated in 1999.
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