■先前的研究已经证明了剖宫产子宫肌瘤切除术的安全性。我们的研究旨在揭示长期围产期,产科,通过比较不同的剖宫产子宫肌瘤切除术(CM)的手术效果。
■这项回顾性的多中心病例对照研究涉及7家医院,包括在2015年至2020年期间接受反复剖宫产(CS)的226例单胎妊娠。在这些怀孕中,226例中的113例患有CM(A组),113例仅有CS(B组)。在进行CM的113例病例中,58例接受了子宫内膜肌瘤切除术(EM)(A1亚组),55例接受了浆膜子宫肌瘤切除术(SM)(A2亚组)。两组在产科方面进行了比较,围产期,和手术结果,纤维瘤复发,子宫肌瘤切除术瘢痕愈合率,并注意到粘附形成。
■两组之间在产妇年龄方面没有显着差异,身体质量指数,妊娠,奇偶校验,和先前CS的肌瘤直径(p>0.05)。在围产期和产科评估中,两组之间在新生儿体重方面没有显着差异,阿普加得分,胎儿生长受限,早产胎膜早破,早产,妊娠期高血压,和糖尿病(p>0.05)。肌瘤复发率为28.3%,子宫肌瘤剔除术后瘢痕愈合良好率为99.1%。就CS持续时间而言,两组之间没有差异,术前和术后血红蛋白水平,围手术期输血率,高热发病率,住院时间延长(p>0.05)。在粘附形成方面,虽然SM组的粘连率高于EM组,组间无统计学差异.
■这项研究表明,在CM之后的怀孕中,产科,围产期,手术结局不受影响.妇产科医生可以安全地使用CM,无论是经子宫内膜还是浆膜技术,因为它是一种安全有效的方法,具有长期的效果。
UNASSIGNED: The safety of cesarean myomectomy has been proven by previous studies. Our study aimed to reveal the long-term perinatal, obstetric, and surgical outcomes of cesarean myomectomy (CM) by comparing different CM techniques.
UNASSIGNED: This retrospective multicentric case-control study involved 7 hospitals and included 226 singleton pregnancies that underwent repeated cesarean section (CS) between 2015 and 2020. Among these pregnancies, 113 of 226 cases had CM (Group A), and 113 had only CS (Group B). Of the 113 cases in which CM was performed, 58 underwent endometrial myomectomy (EM) (Subgroup A1) and 55 underwent serosal myomectomy (SM) (Subgroup A2). The groups were compared in terms of obstetric, perinatal, and surgical outcomes, and fibroid recurrence, myomectomy scar healing rate, and adhesion formation were noted.
UNASSIGNED: There was no significant difference between the groups in terms of maternal age, body mass index, gravidity, parity, and fibroid diameter in previous CS (p > 0.05). In the perinatal and obstetric evaluation of the groups, there was no significant difference between the groups in terms of neonatal weight, Apgar score, fetal growth restriction, preterm premature rupture of membranes, preterm delivery, hypertension in pregnancy, and diabetes mellitus (p > 0.05). The fibroid recurrence rate was 28.3%, and the myomectomy scar good healing rate was 99.1%. There was no difference between the groups in terms of CS duration, preoperative and postoperative hemoglobin levels, perioperative blood transfusion rates, febrile morbidity, and prolonged hospitalization (p > 0.05). In terms of adhesion formation, although the adhesion rate of the SM group was higher than that of the EM group, no statistically significant difference was detected between the groups.
UNASSIGNED: This study showed that in pregnancies following CM, obstetrical, perinatal, and surgical outcomes were unaffected. Obstetricians can safely use CM, either the trans-endometrial or serosal technique, as it is a safe and effective method with long-term results.