[Study on laparoscopic surgery in treatment of caesarean scar pregnancy]

To investigate the safety and feasibility of laparoscopic removal of exogenous caesarean scar pregnancy (CSP).

From January 2009 to May 2011, 71 patients with CSP treated in Shengjing Hospital of China Medical University were studied retrospectively. Thirty-nine patients were treated with hysteroscopic excision of CSP, while 32 patients were treated with laparoscopic surgery. The following clinical parameters were compared, including intraoperative blood loss, quantity of postoperative uterine drainage, postoperative hospital days, the time for the mass absorption and the return of β-hCG to normal were studied.

Two cases in the hysteroscopic group were transformed to abdominal surgery because of introperative bloody loss, the 37 cases underwent hysteroscopic surgery successfully with the ultrasound supervision and guidance.Laparoscopic surgery were successfully completed in all 32 cases.In hysteroscopic group, the operation time, the time for the return of serum β-hCG to normal, postoperative uterine drainage volume and the postoperative hospital stay were (44 ± 18) minutes, (27 ± 5) days, (38 ± 12) ml, (3.8 ± 0.7) days.While, in laparoscopic group, they were (100 ± 21) minutes, (17 ± 4) days, (19 ± 6) ml, (3.5 ± 0.6) days, respectively, the differences reached statistically significant (all P < 0.05). But the amount of intraoperative bleeding were was (113 ± 63) ml in hysteroscopic group and (109 ± 59) ml in laparoscopic group, the difference was not statistically significant (P > 0.05). The duration of absorption of mass were (88 ± 17) days in hysteroscopic group.In laparoscopic group, the mass were completely removed.

Laparoscopic exicion of CSP could be suitable in treatment of exogenous CSP which offers advantages including prompt recovery, blood loss and hospital stays. This management could repair the uterine scars, reduce the reoccurring risk and conservate the fertility potential.