Randomized Control Study of Extra Peritoneal Verses Trans Peritoneal Cesarean Section in View of Operative Morbidity

Abstract

Introduction: Increase incidence of caesarean section is a major concern in todays era. Ceaser may be performed in one of the three way, by classic technique, by lower segment or by some form of extraperitoneal cesarean section. The earliest extraperitoneal technique used was Latzko’s as introduced by Dr Henry Burns. Extraperitoneal cesarean section is a useful method of preventing postoperative morbidity in form of infections & adhesions. Early ambulation , Start oral fluids immediately and get the patient out of bed as soon as the anesthesia worn off are supposed to be advantages of this new study of old technique. Objective: To evaluate advantages or disadvantages of extra peritoneal caesarean section over trans peritoneal caesarean section. Study Design: Single blinded Randomized prospective control triel were performed over 66 patients in our tertiary care institute. Intra operative complications morbidity and outcome compaired by scaling signs, symptoms & examination findings by single consultant. Results: Patients of ECS had better score for postoperative pain, ambulation & oral intake there were less requirement of analgesic in ECS group. Postoperative nausea, shoulder pain febril episodes peritonitis genitourinary tract infection & bowel discomfort were very minimal in ECS group compaire to TCS group. Conclusion: An extra peritoneal csection is definitely advantageous over transperitoneal approach of lower segment caesarean section. There is no need for postoperative starvation, and ileus after this method is rare. Early mobilization reduces the risk of thrombosis and shortens postoperative pain. Less pain makes early commencement of breastfeeding easier within the first hours after the operation. This will also help contraction and involution of the uterus. Early removal of stitches reduces the risk of infection and keloids.