title: [Clinical observation of Stark cesarean section as secondary abdominal surgery].
abstract: OBJECTIVE
  To analyze secondary abdominal surgery after Stark cesarean section.
  
  
  METHODS
  A retrospective analysis of the secondary operation after cesarean section was performed. Group A was Stark cesarean section (n = 89), group B was the longitudinal incision cesarean section (n = 212), and group C was Pfannenstiel incision cesarean section (n = 52). Stark cesarean section was compared with Pfannenstiel incision cesarean section and the longitudinal incision cesarean section in abdominal wall scar healing, adhesion of rectus muscles, peritoneum, omentum, and healing or adhesion of visceral peritoneum.
  
  
  RESULTS
  The rate of good abdominal incision healing and slender scar was 86.5% (77/89) in group A, 29.3% (62/212) in group B, and 75.0% (39/52) in group C, respectively. The rate of adhesion of rectus muscles was 25.8% (23/89) in group A, 53.8% (114/212) in group B, and 13.5% (12/89) in group C, respectively. The rate of adhesion of omentum was 13.5% (12/89) in group A, 56.1% (119/212) in group B, and 25.0% (13/52) in group C, respectively. The rate of peritoneal adhesion was 15.7% (14/89) in group A, 46.2% (98/212) in group B, and 11.5% (6/52) in group C, respectively. Only one case in group C the peritoneum was not healed. The rate of adhesion of visceral peritoneum was 15.7% (14/89) in group A, 55.2% (117/212) in group B, and 13.5% (7/52) in group C, respectively. Abdominal wall scar healing, adhesion of rectus muscles, omentum, peritoneum, and visceral peritoneum in group A were all better than group B. The difference was statistically significant (P < 0.05). There were no differences between group A and group C (P > 0.05).
  
  
  CONCLUSIONS
  The study shows that the Stark cesarean section is better than the longitudinal incision cesarean section in healing of abdominal wall scar, adhesion of rectus muscles, omentum, peritoneum, and visceral peritoneum, but compared with Pfannenstiel incision cesarean section, there is no difference statistically. However, the advantages of the Stark cesarean section lie in short surgical time, few injury, little bleeding, quick recovery, and short hospital stay time, thus it should be further popularized.
authors.affiliation: Obstetric and Gynecologic Center, Second Affiliated Hospital of Tsinghua University, Beijing 100049, China.
authors.forename: Yan-yan
authors.initials: YY
authors.lastname: Ma
authors.forename: Xin-li
authors.initials: XL
authors.lastname: Zhu
authors.forename: Yue
authors.initials: Y
authors.lastname: Dong
authors.forename: Yan-qin
authors.initials: YQ
authors.lastname: Wang
authors.forename: Zhi-min
authors.initials: ZM
authors.lastname: Zheng
authors.forename: Rong-jun
authors.initials: RJ
authors.lastname: Zhang
authors.forename: Yan
authors.initials: Y
authors.lastname: Xu
authors.forename: Juan-juan
authors.initials: JJ
authors.lastname: Zhao
mesh_terms: D000005:Abdomen / Q000601:surgery*; D002585:Cesarean Section / Q000009:adverse effects / Q000379:methods*; D002921:Cicatrix; D005260:Female; D006801:Humans; D010532:Peritoneal Diseases / Q000209:etiology* / Q000601:surgery; D010537:Peritoneum / Q000473:pathology; D012086:Reoperation; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000473:pathology; D014945:Wound Healing