Comparison of blunt and sharp dissection techniques during cesarean hysterectomy in placenta percreta.

Abstract

Objectives: This study aimed to compare the effects of the blunt dissection technique (BDT) with finger and the sharp dissection technique (SDT) with scissors during cesarean hysterectomy (CH) in patients with placenta percreta.

Material and methods: We included 70 patients with placenta percreta who underwent CH in a territory hospital between 2020 and 2023. The patients were divided into two groups: Group 1 included 34 patients who underwent blunt bladder dissection, and Group 2 included 36 patients who underwent sharp bladder dissection. Demographic data, operative complications, surgical parameters, and transfusion rates were compared between the two groups.

Results: BDT was associated with a statistically significant reduction in operation time compared to SDT (95.62 ± 20.76 min vs 107.08 ± 26.04 min, p = 0.046). Moreover, the rate of bladder injury was significantly lower in the BDT group compared to the SDT group (11.8% vs 33.3%, p = 0.032). Although there were no significant differences in blood transfusion products between the two groups, postoperative transfusion amounts tended to be lower in the BDT group.

Conclusions: BDT may be a proper surgical method to reduce bladder injury rates and operation time compared to SDT in CH of placenta percreta cases.