The Effect Analysis Of Different Surgical Methods On Previous Cescarean Scar Defect

ObjectiveCompare the clinical therapeutic effects through the ways of vaginal operation and hysteroscopy combined with laparoscopy. Individualized treatment programs are developped, setting indiidualized treatment, improve satisfaction.Methods46 patients who were diagnosed as cesarean scar diverticulum,and are divided into hysteroscopy combined with laparoscopy in 23 cases and vaginal surgery in 23 cases. All are operated successfully, completed follow-up data. sociological analysissed of past data:age, reproductive history, menstrual history and clinical features, reasons of previous cesarean section, laboratory test. The results were compared include mean operative time, blood loss,postoperative discharge time, total hospital costs, length of stay, postoperative recovery period, scarring diverticulum repair, as well as postoperative changes in quality of life and treatment satisfaction and other indicators. Using statistical software SPSS19.0 data processing, analysis(P <0.05).Results1.46 cases PCSD patients, aged 23～42 years, mean age 32.5±2.6 years. What in the treatment causes:simple menstruation is 50.5%, and some patients accompanied by an increase in the amount of change, irregular uterine bleeding associated with chronic pelvic pain is 30.5%, seven cases of asymptomatic by the longer pre-pregnancy physical examination are found that 15.3%, other 3.7%.2.Compared with the vaginal group, hysteroscopy combined with laparoscopy has longer length of operativing time, the high total cost of hospitalization, but the blood loss, the total number of days of hospitalization was significantly reduced, the difference was statistically significant (P<0.05), no significant statistical difference in postoperative discharge time aspect.3.Postoperative follow-up found that two groups of patients after the menstrual cycle recovery rate and uterine diverticulum repair effects are good, Palace belly menstrual recovery efficiency of the combination group (87%),uterine diverticulum repair efficiency (86%) and vaginal compared (respectively 85%and 86%) showed no significant difference (P>0.05), but the former in terms of efficiency were significantly higher than the latter, although no significant difference (P>0.05).Conclusions1.PCSD mainly are menstrual extension and abnormal uterine bleeding, and patients with asymptomatic PCSD are guadually increased because medical diagnosis before pregnancy rate;2.For PCSD treatment, palace laparoscopic surgery compared to vaginal surgery shows less bleeding, faster recovery, shorter hospital stay, efficient, high satisfaction and other advantages so on, and ti is more suited to the current general hospitals and specialist hospitals. Meanwhile two procedures are all effective, but special factors of patients, individual treatment, effective, economical and safe surgical treatment are all taked into account.