Extraperitoneal versus transperitoneal cesarean section: a retrospective study

Ji, Chao; Chen, Meng; Qin, Yichen

doi:10.1080/00325481.2022.2124774

Cited by 4 publications

(7 citation statements)

References 16 publications

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“…The results are comparable with the work of C. Ji et al [25] and MB Sentrurk [30]; no statistical signi cance was found between the EXP and TPC groups in gestational weeks, newborn weight, or Apgar score. A statistically signi cant difference was found between the EXP group and TPC group for BMI.…”

Section: Discussionsupporting

confidence: 88%

“…Differences in red blood cell laboratory tests and bleeding between the EXP and TPC groups were not found to be the same as those in the work of Chao Ji et al [25]. When caesarean section was indicated for uterine inertia, the values of leukocytes and CRP were higher in the TPC group.…”

Section: Discussionsupporting

confidence: 41%

“…Crichton et al [24] described EXP caesarean-as a simple surgery, but the procedure is possibly demanding for an average perinatology surgeon. Today, most EXP procedures are performed by experienced gynaecology surgeons who are familiar with the paravesical space and position of the umbilical ligament and have much experience in performing different pelvic surgeries [25].…”

Section: Introductionmentioning

confidence: 99%

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Extraperitoneal caesarean advantages: Less pain, faster recovery, no formation of intraperitoneal adhesions and future prevention against new antibiotic-resistant bacterial strains?

Bačić

Barčot²,

Sabljić³

et al. 2023

Preprint

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Purpose The main advantage of extraperitoneal (EXP) caesarean section 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 EXP caesarean sections were performed. From 88 EXP caesarean arm 11 patients were exclude because opening of peritoneum during procedure. Three women were below 37 weeks gestation and were excluded. A comparison was made with 90 patients who underwent standard transperitoneal (TPC) caesarean section. For both groups, the inclusion criterion was uterine inertia as an indication for caesarean section. Only pregnant woment from 37 to 42 weeks were included. After this, 51 patients remained in the EXP arm, and 49 remained in the TPC arm. Results No difference was found in gestational weeks, newborn weight, or Apgar score between the EXP and TPC groups. Standard blood tests, such as erythrocyte (Er), haemoglobin (Hgb) and haematocrit (Htc) tests, were not significantly different in EXP and TPC groups. In the TPC group, body mass index (BMI) was significantly higher (p = 0,04). The operative times between the groups were just above statistical significance (p = 0,06). Leukocytes, C-reactive protein (CRP) and postoperative infection were statistically higher (p = 0,005, p = 0,002, p = 0,04 retrospectively) in the TPC group. The bilirubin value and incidence of newborn febrility were not significantly different between the EXP and TPC groups. The use of Tramadol + Metamizol at 3 hours (p = 0,009), 6 hours (p = 0,01), and 9 hours (p = 0,01) and the use of diclofenac at 6 hours (p = 0,001), 12 hours (p = 0,009), and 18 hours (p = 0,01) after surgery were statistically significantly in the TPC group. Additionally, the first bowel movement at 24, 48, and 72 hours after surgery was statistically significantly earlier in the EXP group (p = 0,02 to p = 0,005). In small group of patients who underwent a TPC section after an EXP caesarean section, intraperitoneal adhesions were not found; in another group of patients who underwent an TPC caesarean section and then again TPC section, adhesions were found in 12 patients (p = 0,04). Conclusion Similar to other studies EXP caesarean have, less pain, a faster first bowel movement and faster recovery with no difference in Apgar score were found in our study. The small group of women who underwent a TPC section after an EXP caesarean section showed no intraperitoneal adhesions (p = 0,04). This study analysed only C-sections in patients with uterine inertia who were predisposed to infection, and more infections were observed in the TPC group. Protective effect EXP caesarean for infection is proven in era before usage of antibiotics and could be very important in new era of antibiotic-resistant bacterial strains. EXP caesarean sections could be a good solution in the fight against adhesions and infection in women who undergo second, third or even fourth caesarean sections.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 41%

Section: Introductionmentioning

confidence: 99%

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Extraperitoneal caesarean advantages: Less pain, faster recovery, no formation of intraperitoneal adhesions and future prevention against new antibiotic-resistant bacterial strains?

Bačić

Barčot²,

Sabljić³

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…There is no consensus on the duration of the operation. That is, while some researchers argue that EPCS takes longer than TPCS [13,14], some authors argue the opposite [7,8,12]. We are of the opinion that the experience of surgeons may be an important factor in this.…”

Section: Discussionmentioning

confidence: 89%

Minimally Invasive Cesarean Section – Extraperitoneal Cesarean Section. The Outcomes of Applying to the Same Patient More than Once. Case Series

Jafarzade

2023

Z Geburtshilfe Neonatol

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Background Extraperitoneal caesarean section (EPCS) provides intraoperative and postoperative advantages to patients compared to transperitoneal (TPCS). Nevertheless, it is less preferred. Methods Extraperitoneal caesarean section (EPCS) is a type of caesarean section performed without entering the peritoneal cavity. Results In this study, EPCS was successfully performed again in patients who had previously undergone EPCS. Conclusion This method, which reduces maternal mortality and health expenditures, can be performed more than once.

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“…The positive benefits of EXPCS include a 4.5fold lower risk of peritonitis, a 14-fold lower risk of formation of pelvic abscesses, a 2.5-fold lower risk of the need for further surgical procedures, and a 4-fold lower risk for late hemorrhage [17]. Today, most EXPCSs are performed by experienced gynecology surgeons who are familiar with the paravesical space and position of the umbilical ligament and have a good deal of experience in performing different pelvic surgeries [18,19].…”

Section: Discussionmentioning

confidence: 99%

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

Bačić,

Hrgović,

Cerovac

et al. 2024

Z Geburtshilfe Neonatol

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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.

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Extraperitoneal versus transperitoneal cesarean section: a retrospective study

Cited by 4 publications

References 16 publications

Extraperitoneal caesarean advantages: Less pain, faster recovery, no formation of intraperitoneal adhesions and future prevention against new antibiotic-resistant bacterial strains?

Extraperitoneal caesarean advantages: Less pain, faster recovery, no formation of intraperitoneal adhesions and future prevention against new antibiotic-resistant bacterial strains?

Minimally Invasive Cesarean Section – Extraperitoneal Cesarean Section. The Outcomes of Applying to the Same Patient More than Once. Case Series

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

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