New method for surgical treatment of uterine scar insuffisiency after a previous cesarean section using an intrauterine manipulator with a groove


Citar

Texto integral

Acesso aberto Acesso aberto
Acesso é fechado Acesso está concedido
Acesso é fechado Acesso é pago ou somente para assinantes

Resumo

Aim. The evaluation of the laparoscopic surgery for cesarean scar insufficiency after a previous cesarean section. Material and methods. Between 2018 and 2019, 15 patients with uterine scar dehiscence were managed at the department of operative gynecology, Federal State National Medical Research Center of Obstetrics, Gynecology and Perinatology named after. V.I. Kulakov, Russian Ministry of Helthcare. Results. A new method was developed for laparoscopic metroplasty of uterine scar insufficiency using a new intrauterine manipulator with a groove. The use of the new method resulted in the optimization of the insufficient scar excision, which is evaluated such surgical stages, as: scar incision; conjoin to connecting margins and myometrial suturing of all layers, for repair the complete myometrial segment, that allows for effective restoration of the lower uterine segment with the formation of a mature scar. Conclusion. The new intrauterine manipulator with a groove can be recommended for routine clinical application to optimize the management of uterine scar insufficiency after previous surgery.

Texto integral

Acesso é fechado

Sobre autores

Z. Makiyan

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: makiyan@mail.ru
Principal Investigator, Doctor of medicine.

Leyla Adamyan

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: aleyla@inbox.ru
Academician of RAS, professor, doctor of medicine. Head op operative gynecology

Valeriy Karabach

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

MD, head of operation room

Vladimir Chuprynin

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: v_chuprynin@oparina4.ru
PhD, Head of the Surgery Department

Bibliografia

  1. Vogel J.P., Betran A.P., Vindevoghel N., Souza J.P., Torloni M.R., Zhang J., et al. WHO Multi-Country Survey on Maternal and Newborn Health Research Network. Use of the Robson classification to assess caesarean section trends in 21 countries: a secondary analysis of two WHO multicountry surveys. Lancet Global Health. 2015; 3(5): e260-70. doi: 10.1016/S2214-109X(15)70094-X.
  2. Еремкина В.И., Гарифуллова Ю.В. Реконструктивно-восстановительная пластика несостоятельного рубца на матке влагалищным доступом вне беременности. Практическая медицина. 2014; 4: 46-8. eLIBRARY ID: 21845031
  3. Robson M., Hartigan L., Murphy M. Methods of achieving and maintaining an appropriate caesarean section rate. Best Pract Res Clin Obstet Gynaecol. 2013; 27: 297-308. doi: 10.1016/j.bpobgyn.2012.09.004.
  4. Коган О.М., Войтенко Н.Б., Зосимова Е.А., Мартынова Э.Н., Нерсесян Д.М., Бубникович А.А. Алгоритм ведения пациенток с несостоятельностью послеоперационного рубца на матке после кесарева сечения. Клиническая практика. 2018; 3(9): 38-43. doi: 10.17816/clinpract09338-43
  5. Буянова С.Н., Пучкова Н.В. Несостоятельный рубец наматке после кесарева сечения: диагностика, тактика ведения, репродуктивный прогноз. Российский вестник акушера-гинеколога. 2011; 4: 36-8.
  6. Манухин И.Б., Мурашко А.В., Мынбаев О.А. Повторное кесарево сечение с хирургической позиции: систематический обзор. Журнал акушерства и женских болезней. 2011; 60 (Спецвыпуск): 69-70.
  7. Глухов Е.Ю., Обоскалова Т.А., Столин А.В. и др. Рубец на матке после кесарева сечения в клинике и эксперименте. Российский вестник акушера-гинеколога. 2014; 1: 10-8.
  8. Краснопольская К.В., Попов А.А., Чечнева М.А., Федоров А.А., Ершова И.Ю. Прегравидарная метропластика по поводу несостоятельного рубца на матке после кесарева сечения: влияние на естественную фертильность и результаты ЭКО. Проблемы репродукции. 2015; 21(3): 56-62. https://doi.org/10.17116/repro201521356-62
  9. Mathai M., Hofmeyr G.J., Mathai N.E. Abdominal surgical incisions for caesarean section. Cochrane Database Syst Rev. 2013; (5): CD004453. doi: 10.1002/14651858.CD004453.pub3.
  10. Bij de Vaate A.J., Brolmann H.A., van der Voet L.F., van der Slikke J.W., Veersema S., Huirne J.A. Ultrasound evaluation of the Cesarean scar: relation between a niche and postmenstrual spotting. Ultrasound Obstet Gynecol. 2011; 37(1): 93-9. doi: 10.1002/uog.8864.
  11. van der Voet L.F., Bij de Vaate A.M., Veersema S., Brolmann H.A., Huirne J.A. Long-term complications of caesarean section. The niche in the scar: a prospective cohort study on niche prevalence and its relation to abnormal uterine bleeding. BJOG. 2014; 121(2): 236-44. doi: 10.1111/1471-0528.12542.
  12. van der Voet L.F., Jordans I.P.M., Brolmann H.A.M., Veersema S., Huirne J.A.F. Changes in the Uterine Scar during the First Year after a Caesarean Section: A Prospective Longitudinal Study. Gynecol Obstet Invest. 2018; 83(2):164-70. doi: 10.1159/000478046.
  13. Timor-Tritsch I.E., Monteagudo A., Santos R., Tsymbal T., Pineda G., Arslan A.A. The diagnosis, treatment, and follow-up of cesarean scar pregnancy. Am J. Obstet Gynecol. 2012; 207(1): 44. e41-13. doi: 10.1016/j.ajog.2012.04.018.
  14. Sholapurkar S.L. Surgical techniques at caesarean might modify placenta accreta risk. BJOG. 2015;122(1):143. doi: 10.1111/1471-0528.13017.
  15. Международная классификация болезней 10 пересмотра (МКБ-10). [International Classification of Diseases 10th Revision (ICD-10). (in Russian)] https://icd.who.int/browse10/2016/en#/O30-O48
  16. Nikkels C., Vervoort A., Mol B.W., Hehenkamp W.J.K., Huirne J.A.F., Brolmann H.A.M. IDEAL framework in surgical innovation applied on laparoscopic niche repair. Eur J. Obstet Gynecol Reprod Biol. 2017; 215: 247-53. doi: 10.1016/j.ejogrb.2017.06.027.
  17. Sumigama S., Sugiyama C., Kotani T., Hayakawa H., Inoue A., Mano Y., Tsuda H. , et al. Uterine sutures at prior caesarean section and placenta accreta in subsequent pregnancy: a case-control study. BJOG. 2014; 121(7): 866-74. doi: 10.1111/1471-0528.12717. discussion 875.
  18. Abalos E., Addo V., Brocklehurst P., El Sheikh M., Farrell B., Gray S., Hardy P., et al. Caesarean section surgical techniques (CORONIS): a fractional, factorial, unmasked, randomised controlled trial. Lancet. 2013; 382(9888): 234-48. doi: 10.1016/S0140-6736(13)60441-9.
  19. Marotta M.L., Donnez J., Squifflet J. et al. Laparoscopic repair of postcesarean section uterine scar defects diagnosed in nonpregnant women. J. Minimal Invasive Gynecol. 2013; 20(3): 386-91. doi: https://doi.org/10.1016/ j.jmig.2012.12.006
  20. Makiyan Z. Endometriosis origin from primordial germ cells. Organogenesis. 2017; 13(3): 95-102. doi.org/10.1080/15476278.2017.1323162
  21. Makiyan Z. New theory of uterovaginal embryogenesis. Organogenesis 2016; 12(1): 33-41; doi.org/10.1080/15476278.2016.1145317
  22. Xu W., Wang M., Li J., Lin X., Wu W., Yang J. Laparoscopic combined hysteroscopic management of cesarean scar pregnancy with temporary occlusion of bilateral internal iliac arteries: A retrospective cohort study. Medicine (Baltimore). 2019; 98(37): e17161. doi: 10.1097/MD.0000000000017161.

Arquivos suplementares

Arquivos suplementares
Ação
1. JATS XML
Baixar

Declaração de direitos autorais © Bionika Media, 2020

Este site utiliza cookies

Ao continuar usando nosso site, você concorda com o procedimento de cookies que mantêm o site funcionando normalmente.

Informação sobre cookies