Ameta-analysis Of The Clinical Study About The Transvaginal Surgery And The Laparoscopic Srugery For Exogenous CSP

Objective:A meta-analysis evaluates the efficacy and safety of the transvaginal surgery and the laparoscopic surgery for exogenous cesarean scar pregnancy(CSP)by RevMan5.3 and softwares.Method:Search strategy was developed in accordance with the requirements of the Cochrane Collaboration Workbook.Databases was searched,including PubMed,the Cochrane Library,EMBASE,BIOSIS,LILACS,Google,CNKI,CBM and VIP resource systems,along with manual and other retrieval.Randomized Controlled Trials(RCT)which are evaluated the treatment of the transvaginal surgery and the laparoscopic surgery for exogenous CSP from building to in March 2017 was collected.RevMan 5.3 softwares was used for Statistical analysis.Result:2213 literatures was searched firstly,only 40 randomized controlled trials met the inclusion criteria and 2200 patients in total.Meta-analysis showed that there were significant differences in complication,estimated blood loss,operative time,postoperative anal exhaust time,postoperative hospital stay,hospitalization expenses(P<0.05);there were no significant differences in the treatment efficiency,,serum blood human chorionic gonadotropin(HCG)resolution time,menstruation recovery time and postoperative vaginal bleeding time(P>0.05).Conclusion:The meta-analysis showed that compared with the laparoscopic surgery,the incidence of complications for exogenous CSP was lower,the estimated blood loss and hospitalization expenses was less,the operative time,postoperative anal exhaust time,postoperative hospital stay was shorter.This was no difference with the treatment rate,the time of blood human chorionic gonadotropin(HCG)approaching to normal and the time of menstruation recovery.For the postoperative vaginal bleeding time,due to the existing sample is too small,not yet enough conclusions.