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首页> 外文期刊>International Journal of Reproduction, Contraception, Obstetrics and Gynecology >Non-descent vaginal hysterectomy in women with previous caesarean section scar: our experience
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Non-descent vaginal hysterectomy in women with previous caesarean section scar: our experience

机译：曾有剖腹产疤痕的女性非下降性阴道子宫切除术：我们的经验

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Background: Hysterectomy is one of the common gynaecological major surgeries performed worldwide. In spite of technological advancement with laparoscopic and robotic hysterectomy conventional hysterectomy through vaginal route of nonprolapse uterus popularly known as, Non-Descent Vaginal Hysterectomy (NDVH) remains a justifiable cost effective, cosmetically appealing option especially in resource-crunched developing country. NDVH in post caesarean scarred uterus too a technically challenged procedure requiring skills and expertise. Assessment of technical feasibility and safety of non-descent vaginal hysterectomy in women with previous caesarean section scar were studied. Methods: The study was a prospective observational study of 72 patients with LSCS scar requiring hysterectomy for benign conditions were selected based on the inclusion and exclusion criteria carried out from June 2012 to May 2017. Operating time, blood loss, surgical techniques, intra/postoperative challenges, conversion to laparotomy or laparoscopic assistance and length of hospital stay were recorded for each case. Patients were followed up till 03 months of surgery. Results: Vaginal hysterectomy was successful in all cases. Morcellation, bisection or myomectomy, were done in 86% cases. Two patients had bladder injury, which was repaired vaginally, two cases required support of laparoscopy. No patients needed blood transfusion. None of the patients were converted to laparotomy. Conclusions: Vaginal hysterectomy is a safe and effective procedure for benign non-prolapsed uteri in women with previous caesarean section scar when uterine size is less than 14 weeks. Standby operating laparoscopy provides added advantages to surgeon in doubtful or difficult cases to avoid conversion laparotomy.
机译：背景：子宫切除术是世界范围内常见的妇科主要外科手术之一。尽管腹腔镜和机器人子宫切除术在技术上取得了进步，但通过阴道脱垂子宫的常规子宫切除术被普遍称为非下降阴道子宫切除术（NDVH）仍然是合理的，具有成本效益的，吸引人的选择，尤其是在资源匮乏的发展中国家。剖宫产后子宫瘢痕中的NDVH也是一项技术挑战性手术，需要技能和专业知识。对先前剖腹产瘢痕的女性非下降性阴道子宫切除术的技术可行性和安全性进行了评估。方法：该研究是一项前瞻性观察性研究，根据2012年6月至2017年5月进行的纳入和排除标准，选择了72例因良性条件需要行子宫切除术的LSCS瘢痕患者。手术时间，失血量，手术技术，术中/术后记录每例病人的挑战，开腹手术或腹腔镜手术的协助以及住院时间。对患者进行随访直至手术03个月。结果：阴道子宫切除术在所有情况下均成功。 86％的患者进行了粉碎，平分或子宫肌瘤切除术。 2例膀胱损伤，经阴道修复，2例需要腹腔镜检查。没有患者需要输血。所有患者均未接受开腹手术。结论：对于子宫大小小于14周的既往有剖腹产疤痕的女性，阴道子宫切除术是治疗良性非脱垂子宫的安全有效方法。备用腹腔镜检查在疑似或困难情况下为外科医生提供了更多优势，可避免进行腹腔镜手术。

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