title: [Study on 31 cases with cesarean scar pregnancy treated by transvaginal surgery].
abstract: OBJECTIVE
  To study clinical efficacy on cesarean scar pregnancy (CSP) treated by transvaginal surgery.
  
  
  METHODS
  From Jan. 2008 to Mar. 2011, 31 cases with CSP were managed by transvaginal surgery in Anshan Women and Children Hospital. Based on ultrasonograpy examination and intraoperative exposure of lesion, variable surgical options were executed. Fifteen cases in group A were treated by debridement resection and vaginal repair of uterine wall, 7 cases in group B were treated by transvaginal uterine artery ligation and curettage, 9 cases were treated by cutting the anterior wall in the lower uterine segment and repairing uterine. The intraoperative blood loss, operation time, hospital stay, hCG fluctuation at postoperative period and complications were analyzed among those groups.
  
  
  RESULTS
  All cases in 3 groups were cured well in one time. (1) The intraoperative blood loss were (41 ± 21) ml in group A, (27 ± 7) ml in group B and (148 ± 132) ml in group C. There was no statistically different blood loss between group A and group B (P > 0.05), however, the amount blood loss in group C was significantly more than those in group A and group B (P < 0.05). (2) The average surgical time, the mean hospital stay, postoperative recovery time of blood hCG were (40 ± 11) minutes, (4.7 ± 0.8) days and (2.7 ± 1.0) weeks in group A, (44 ± 5) minutes, (4.0 ± 0.8) days and (2.9 ± 1.0) weeks in group B, (40 ± 12) minutes, (4.9 ± 1.0) days and (2.8 ± 0.9) weeks in group C. Those clinical index were no statistically different among those 3 groups (P > 0.05). (3) No bladder injury and other complications were observed in those groups.
  
  
  CONCLUSIONS
  Transvaginal surgery is efficacy, easy to operate, to keep the uterus, safe and economy in treatment of CSP. Surgery in group A is suitable to treat early and exogenous lesions; surgery in group B is suitable to treat endogenous lesions; surgery in group C is suitable to treat failure cases in group A and B, however, the injury is greater than those in group A and B.
authors.affiliation: Department of Obstetrics and Gynecology, Anshan Women and Children Hospital, Anshan, China. frlhy166@163.com
authors.forename: Hai-yan
authors.initials: HY
authors.lastname: Lu
authors.forename: Wen-hua
authors.initials: WH
authors.lastname: Zhang
authors.forename: Jun
authors.initials: J
authors.lastname: Shan
authors.forename: Qi-shan
authors.initials: QS
authors.lastname: Tian
authors.forename: Xiu-qing
authors.initials: XQ
authors.lastname: Zhang
authors.forename: Li-chun
authors.initials: LC
authors.lastname: Wu
authors.forename: Yan-xia
authors.initials: YX
authors.lastname: Zhou
authors.forename: Sai
authors.initials: S
authors.lastname: Li
authors.forename: Yi-mei
authors.initials: YM
authors.lastname: Peng
authors.forename: Dong
authors.initials: D
authors.lastname: Li
authors.forename: Li-na
authors.initials: LN
authors.lastname: Hu
mesh_terms: D016063:Blood Loss, Surgical; D002585:Cesarean Section / Q000009:adverse effects*; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D002921:Cicatrix / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D003475:Curettage; D005260:Female; D006801:Humans; D007902:Length of Stay; D061646:Operative Time; D011183:Postoperative Complications; D011247:Pregnancy; D011271:Pregnancy, Ectopic; D012189:Retrospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography; D055988:Uterine Artery / Q000601:surgery; D055357:Uterine Artery Embolization; D014599:Uterus / Q000098:blood supply / Q000000981:diagnostic imaging / Q000601:surgery; D014945:Wound Healing
chemical_list: D018997:Chorionic Gonadotropin, beta Subunit, Human