宫腔镜联合腹腔镜手术治疗完全纵隔子宫伴阴道纵隔的临床疗效

Clinical efficacy of transcervical resection of septum via hysteroscopy combined with laparoscopy in treating complete septate uterus and longitudinal vaginal septum

目的：探讨宫腔镜联合腹腔镜手术治疗完全纵膈子宫伴阴道纵隔的临床效果。方法：回顾性分析我院妇科微创中心行腹腔镜监护下宫腔镜子宫纵隔切除＋阴道纵隔切除术的40例完全纵隔子宫伴阴道纵隔患者的临床资料，并随访其术后妊娠结局。结果：40例患者成功随访1～6年．术后累计妊娠46次，自然流产率由术前的87.3％下降到30．4％，足月活产率由0．0％上升到58．7％．无胎盘植入、胎盘粘连等妊娠期并发症发生。结论：宫腔镜联合腹腔镜手术安全有效，可明显改善纵隔子宫合并阴道纵隔患者的妊娠结局，不增加孕期并发症，建议在临床上推广应用。

Objective： To evaluate the clinical effect of transcervical resection of septum （TCRS） following hysteroscopy combined with laparoscopy in patients with complete septate uterus and longitudinal vaginal septum. Methods： A retrospective study involved 40 patients with complete septate uterus and longitudinal vaginal septum who had TCRS was conducted. Results： Totally 40 patients were followed up for 1-6 years. A total of 46 pregnancies were conceived. After operation, the miscarriage rate was significantly decreased （87.3% vs 30.4%） and the live birth rate was significantly increased （0.0% vs 58.7%）. In the research objects, no complication such as placenta implantation and placental adherence was observed. Conclusion： The hysteroscopic and laparoscopic TCRS is an ideal way to treat complete septate uterus and longitudinal vaginal septum and should be widely used in clinical practice.