Comparison of the Efficacy of Two Laparoscopic Surgical Procedures Combined with Hysteroscopic Incision in the Treatment of Cesarean Scar Diverticulum

Figures & data

Figure 1. (A) Hysteroscopy of the cesarean scar defect (CSD). (B) Hysteroscopy after electrical resection of the scar (canal opening) and electrocoagulation of the diverticular endometrium. (C) Laparoscopy of the CSD. (D) Laparoscopic visualization of the diverticulum with guidance from the light source of the hysteroscope after opening and deflecting the vesicouterine pouch. (E) The muscle flap filling suture method: a monopolar electrical probe was used to make a transverse incision in the myometrium 1 cm above the diverticulum to a depth of approximately 0.5 cm. (F) The muscle flap filling suture method. (G) After muscle flap filling suture. (H) The folding suture method. (I) After folding suture.

Table 1. Analysis of the basic clinical data of the patients in the two groups $(\overline{x}\pm s).$

	Age (years)	Time between the surgery and the last cesarean section (years)	Number of cesarean sections	Menstrual period duration before cesarean section (days)	Preoperative vaginal bleeding time (days)	Myometrial thickness at the diverticulum (mm)	Preoperative hemoglobin (g/L)
Muscle flap filling suture group (n = 11)	35.9 ± 2.3	6.1 ± 1.8	1.1 ± 0.3	6.4 ± 0.9	12.7 ± 4.1	2.1 ± 1.4	113.6 ± 39
Folding suture group (n = 12)	32.6 ± 5.2	5.1 ± 2.1	1.2 ± 0.4	6.0 ± 1.4	12.1 ± 6.5	1.8 ± 0.9	126.3 ± 14.2
T value	−1.941	−1.238	0.518	−0.747	−0.281	−0.725	1.048
P value	0.066	0.229	0.610	0.463	0.782	0.476	0.306

Table 2. Analysis of perioperative clinical data of the patients in the two groups (x ± s).

	Intraoperative bleeding (ml)	Postoperative hemoglobin concentration reduction (g/L)	Operation time (min)	Urinary catheter indwelling time (days)	Exhaust time (days)	Maximum body temperature (°C)	Hospitalization days (days)
Muscle flap filling suture group (n = 11)	16.8 ± 11.9	0.98 ± 0.7	90.2 ± 23.4	1.5 ± 0.5	1.2 ± 0.4	37.2 ± 0.2	6.5 ± 2.1
Folding suture group (n = 12)	21.2 ± 15.1	0.83 ± 0.8	84.1 ± 19.0	2 ± 0.9	1.3 ± 0.5	37.1 ± 0.2	6.4 ± 0.9
T value	0.777	−0.480	−0.690	1.828	0.802	−1.208	−0.260
P value	0.446	0.636	0.498	0.082	0.432	0.240	0.798

Table 3. Comparison of surgical efficacy between the patients in the two groups (x ± s).

	Postoperative menstrual period (days)	Menstrual period reduction (days)	Myometrial thickness of lower uterine segment (mm) at 3 months after the operation	Cured (case)	Improved (case)	With residual diverticulum (case)
Muscle flap filling suture group (n = 11)	6.9 ± 1.8	5.8 ± 4.2	6.7 ± 1.8	8	3	3
Folding suture group (n = 12)	7.5 ± 3.0	4.4 ± 3.8	6.3 ± 1.7	6	6	3
T value	−0.574	0.846	0.556
P value	0.572	0.407	0.584	0.400	0.400	1.000