Comparison between extraperitoneal and transperitoneal cesarean section: Retrospective case-control study.

IF 0.7 4区 医学 Q4 OBSTETRICS & GYNECOLOGY Zeitschrift fur Geburtshilfe und Neonatologie Pub Date : 2024-07-16 DOI:10.1055/a-2338-5802
Boris Bačić, Zlatko Hrgović, Anis Cerovac, Ognjen Barčot, Jelena Sabljić, Blagoja Markoski, Mateo Leskur
{"title":"Comparison between extraperitoneal and transperitoneal cesarean section: Retrospective case-control study.","authors":"Boris Bačić, Zlatko Hrgović, Anis Cerovac, Ognjen Barčot, Jelena Sabljić, Blagoja Markoski, Mateo Leskur","doi":"10.1055/a-2338-5802","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>  The main advantage of extraperitoneal cesarean section (EXPCS) is not only less pain, faster recovery, and less potential for infection but also a possible lack of intraperitoneal adhesions.</p><p><strong>Methods: </strong>  In a 3-year period from 2019 to 2022, 88 EXPCSs were performed. A comparison was made with 90 patients who underwent a standard transperitoneal cesarean section (TPCS). For both groups, the inclusion criterion was uterine inertia and prolonged labor as an indication for cesarean section. Only pregnant women from 37 to 42 weeks were included. After this, 51 patients remained in the EXPCS arm, and 49 remained in the TPCS arm.</p><p><strong>Results: </strong>  No statistical difference was found in gestational weeks, newborn weight, Apgar score, erythrocyte (Er), hemoglobin (Hgb), and hematocrit (Htc) values and duration of operative time between the EXPCS and TPCS groups. Leukocytes, C-reactive protein (CRP) with fever higher than >38°C on the third postoperative day were found statistically significantly (p=0.005) higher in the TPCS group. The usage of tramadol + metamizole at 3, 6, and 9 hours after delivery and diclofenac at 6, 12, and 18 hours after surgery was statistically significantly (p<0.05) higher in the TPCS group. On the visual analog scale (VAS) 24 hours after surgery, a statistically significant difference was found (p = 0.001) between the two groups. In the small group of patients who underwent a TPCS section after an EXPCS, intraperitoneal adhesions were not found; in another group of patients who underwent a TPCS twice, adhesions were found in 12 patients; Fisher's exact test (p=0.04).</p><p><strong>Conclusion: </strong>  The protective effect of EXPCS for infection could be proven in prolonged delivery. EXPCS could be a good solution in the fight against adhesions and infection in women who undergo second, third, or even fourth cesarean sections.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":null,"pages":null},"PeriodicalIF":0.7000,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Zeitschrift fur Geburtshilfe und Neonatologie","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1055/a-2338-5802","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Introduction:   The main advantage of extraperitoneal cesarean section (EXPCS) is not only less pain, faster recovery, and less potential for infection but also a possible lack of intraperitoneal adhesions.

Methods:   In a 3-year period from 2019 to 2022, 88 EXPCSs were performed. A comparison was made with 90 patients who underwent a standard transperitoneal cesarean section (TPCS). For both groups, the inclusion criterion was uterine inertia and prolonged labor as an indication for cesarean section. Only pregnant women from 37 to 42 weeks were included. After this, 51 patients remained in the EXPCS arm, and 49 remained in the TPCS arm.

Results:   No statistical difference was found in gestational weeks, newborn weight, Apgar score, erythrocyte (Er), hemoglobin (Hgb), and hematocrit (Htc) values and duration of operative time between the EXPCS and TPCS groups. Leukocytes, C-reactive protein (CRP) with fever higher than >38°C on the third postoperative day were found statistically significantly (p=0.005) higher in the TPCS group. The usage of tramadol + metamizole at 3, 6, and 9 hours after delivery and diclofenac at 6, 12, and 18 hours after surgery was statistically significantly (p<0.05) higher in the TPCS group. On the visual analog scale (VAS) 24 hours after surgery, a statistically significant difference was found (p = 0.001) between the two groups. In the small group of patients who underwent a TPCS section after an EXPCS, intraperitoneal adhesions were not found; in another group of patients who underwent a TPCS twice, adhesions were found in 12 patients; Fisher's exact test (p=0.04).

Conclusion:   The protective effect of EXPCS for infection could be proven in prolonged delivery. EXPCS could be a good solution in the fight against adhesions and infection in women who undergo second, third, or even fourth cesarean sections.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
腹膜外与经腹膜剖宫产的比较:回顾性病例对照研究。
导言:腹膜外剖宫产术(EXPCS)的主要优势不仅在于疼痛更轻、恢复更快、感染可能性更小,还在于可能不会出现腹腔内粘连:从 2019 年到 2022 年的 3 年间,共实施了 88 例 EXPCS。与 90 名接受标准经腹膜剖宫产术(TPCS)的患者进行了对比。两组患者的纳入标准均为子宫惰性和产程延长作为剖宫产手术的指征。只有 37 至 42 周的孕妇被纳入其中。之后,51 名患者留在了 EXPCS 组,49 名患者留在了 TPCS 组:结果:EXPCS 组和 TPCS 组在孕周、新生儿体重、Apgar 评分、红细胞(Er)、血红蛋白(Hgb)和血细胞比容(Htc)值以及手术时间长短方面均无统计学差异。术后第三天,TPCS 组的白细胞、C 反应蛋白(CRP)和发热高于 >38°C,显著高于 EXPCS 组(P=0.005)。在产后 3、6 和 9 小时使用曲马多+甲氰咪唑,以及在术后 6、12 和 18 小时使用双氯芬酸,均有显著统计学意义(P=0.005):在产程延长的情况下,EXPCS 对感染的保护作用已得到证实。对于接受第二次、第三次甚至第四次剖宫产手术的产妇来说,EXPCS 是防止粘连和感染的一个很好的解决方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
Zeitschrift fur Geburtshilfe und Neonatologie
Zeitschrift fur Geburtshilfe und Neonatologie OBSTETRICS & GYNECOLOGY-PEDIATRICS
CiteScore
1.10
自引率
0.00%
发文量
166
审稿时长
>12 weeks
期刊介绍: Gynäkologen, Geburtshelfer, Hebammen, Neonatologen, Pädiater
期刊最新文献
[AI-supported decision-making in obstetrics - a feasibility study on the medical accuracy and reliability of ChatGPT]. [Survey on the State, Potential, and Obstacles of the Digital Transformation in Human Milk Banks]. Rare Diseases and Syndromes Observed in Newborn Babies with Idiopathic Hypertrophic Pyloric Stenosis. [Ethical Attitudes and Handling in Prenatal Conflict Situations - A Survey among Obstetricians and Prenatal Diagnosticians in Germany]. Significance of Physical Exercise in Pregnancy: Comparison of Short and Long Exercise Programs.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1