Laparoscopic Reversible Internal Iliac Artery Occlusion In The Treatment Of CSP

Objective:To explore the role of laparoscopic reversible internal iliac artery occlusion in the treatment of cesarean scar pregnancy(CSP).Methods:All cases were from 48 cases of cesarean scar pregnancy who were admitted to the First Affiliated Hospital of Kunming Medical University from October 2015 to January 2018.Their clinical data were collected and analyzed retrospectively.According to different pretreatment programs,they were divided into laparoscopic group and intervention group:16 patients in laparoscopic group,6 of them were treated with laparoscopic reversible internal iliac artery occlusion + scar pregnancy removal,and 10 patients underwent laparoscopic surgery.Reversible internal iliac artery occlusion + resection of the uterine artery;interventional group of 32 patients,22 cases of uterine artery embolization + uterine artery excision,10 cases of uterine artery embolization + abdomen scar pregnancy removal,of which 1 case Intraoperative hemorrhage abdominal hysterectomy.The operative time,intraoperative blood loss,length of hospitalization,hospitalization costs,complications,and time of negative ?-HCG in the two groups were analyzed retrospectively.Results:The operative time of the two groups was compared:laparoscopic surgery time(67.81±19.23)min,interventional group operation time(105.63±44.93)min,and laparoscopic surgery time less than the intervention group(37.82±38.48)min.When the time was compared,the result was P<0.05,and the difference was statistically significant..The hospitalization days of the two groups were compared:the number of hospital stays in the laparoscopic group was(4.50±0.63)days,and the hospitalization days in the intervention group(10.38±7.74)days.The laparoscopic group hospital stay was less than the intervention group(5.88±6.36)days.The two groups were hospitalized.When the time was compared,the result was P<0.05,and the difference was statistically significant.The hospitalization cost of the two groups was compared:laparoscopic group hospitalization costs(13340.43±2740.91)yuan,hospitalization costs of hospitalization costs(17243.97±5338.11)yuan for the intervention group,and hospitalization costs for the laparoscopic group(3903.54±4653.30)yuan less than the intervention group.The hospitalization cost of the patients was compared and the results were P<0.05.The difference was statistically significant.The time of blood P-HCG conversion in two groups was compared:the time of?-HCG negative change in the laparoscopic group was 18.31±6.35 days,and the time of ?-HCG negative change in the intervention group was 24.31 ±7.64d,and the laparoscopic blood was obtained.The time of negative conversion of ?-HCG was shorter than that of the intervention group(6 ± 7.24)days.The time of conversion of?-HCG in the two groups of patients was compared,and the result was P<0.05.The difference was statistically significant.Comparing intraoperative blood loss between the two groups:intraoperative blood loss(48.13±39.83)ml in laparoscopic group,intraoperative blood loss(180.78±701.22)ml in interventional group,and less intraoperative blood loss in the laparoscopic group than in the intervention group(132.65).± 576.10)ml,but the intraoperative blood loss was compared between the two groups,the result was P>0.05,and the difference was not statistically significant..The postoperative complications of the two groups were compared:no complications occurred in the laparoscopic group,and 1(3.125%)patients experienced complications in the intervention group.The incidence of complications in the intervention group was significantly greater than that in the observation group,but the two groups were postoperative Comparing the occurrence of complications,the result was P>0.05,and the difference did not have statistical significance.There were no statistically significant differences between the subgroups of the laparoscopic group in terms of operative time,intraoperative blood loss,hospitalization days,hospitalization costs,and ?-HCG negative time(P>0.05).Conclusions:Laparoscopic reversible internal iliac artery occlusion is more effective than uterine artery embolization in the treatment of cesarean section scar pregnancy.It has the advantages of short operative time,short hospital stay,low hospitalization costs,and short duration of blood ?-HCG conversion after surgery.Etc.For skilled laparoscopic surgery,laparoscopic internal iliac artery occlusion can be used as a pretreatment for cesarean scar pregnancy.