剖宫产切口瘢痕缺损手术方式选择

Selection of surgery modes in scar defect of incision in cesarean cection

剖宫产切口瘢痕缺损(cesarean scar defect,CSD)目前尚无国际统一的定义和治疗方法。对于药物保守治疗无效、症状严重又有生育要求的CSD患者,如有手术意愿可选择手术治疗。手术主要有经阴道、宫腔镜、腹腔镜及宫腹腔镜联合4种方式。几种术式各有优缺点,术者应根据患者临床症状、瘢痕缺损的大小和位置、所在医院手术条件及自身的手术技能制定个体化治疗方案。

There is no international unified definition or treatment for patients with previous cesarean scar defect(CSD).For patients with severe symptoms and fertility requirements who didn’t respond to conservative drug treatment,surgical treatment can be selected if there is a desire for surgery.The four main operation routes are transvaginal,hysteroscopic,laparoscopic and laparoscopic combined with hysteroscopic.Each of these methods has its own advantages and disadvantages,and the surgeons should make an individualized treatment plan according to the clinical symptoms of the patients,the size and location of the diverticulum,the surgical conditions in the hospital and the surgical skills of the operators.