Laparoscopic management of cesarean scar pregnancy: Report of two cases with video-presentation of different operative techniques and literature review

Kathopoulis, Nikolaos; Chatzipapas, Ioannis; Samartzis, Konstantinos; Theodora, Marianna; Lardou, Ioanna; Πρωτόπαπας, Αθανάσιος

doi:10.1016/j.jogoh.2021.102066

Cited by 11 publications

(12 citation statements)

References 49 publications

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“…Alzamora et al 32 reported a case of a patient with CPS who had failed to respond to pharmacologic treatment, but was successfully treated by laparoscopy in combination with vascular clamp placement, and concluded that intraoperative occlusion of both uterine arteries reduces hemorrhage. Kathopoulis et al 33 used metal clips to temporarily occlude both uterine arteries during laparoscopic surgery in two patients with CSP, which reduced the blood supply to the niche and permitted the successful extraction of pregnancy products, scar removal, and repair of the deficit. Both Qian et al 34 and Lina et al 18 also concluded that the intraoperative temporary occlusion of both uterine arteries reduces intraoperative hemorrhage, and the present findings are consistent with this conclusion.…”

Section: Discussionmentioning

confidence: 99%

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A combination of laparoscopy and bilateral uterine artery occlusion for the treatment of type II cesarean scar pregnancy: a retrospective analysis

Wang,

Xue,

Wang

2024

J Int Med Res

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Objective We investigated the efficacy of a combination of laparoscopy and bilateral uterine artery occlusion (BUAO) for the treatment of type II cesarean scar pregnancy (CSP). Methods Patients with type II CSP underwent laparoscopy + bilateral uterine artery embolization (control group) or laparoscopy + BUAO (study group). Data regarding the duration of surgery, intraoperative hemorrhage, postoperative complications, the duration of the hospital stay, and the costs of hospitalization were retrospectively collected. One year later, the time to the return of the β-human chorionic gonadotropin (β-hCG) concentration to normal and to the return of menstruation were compared. Results The duration of surgery, time to the return of menstruation, and incidence of postoperative complications in the study group were significantly less than in the control group, but there was no significant difference in the time for β-hCG to return to normal or the volume of intraoperative hemorrhage. The duration of hospitalization and costs for the control group were higher than those for the study group. Conclusion Laparoscopy in combination with BUAO is associated with minimal trauma, rapid recovery, a short duration of surgery, low cost of hospitalization, and a low postoperative complication rate. Thus, it represents a useful new surgical treatment for type II CSP.

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Section: Discussionmentioning

confidence: 99%

“…Kathopoulis et al . 33 used metal clips to temporarily occlude both uterine arteries during laparoscopic surgery in two patients with CSP, which reduced the blood supply to the niche and permitted the successful extraction of pregnancy products, scar removal, and repair of the deficit. Both Qian et al .…”

Section: Discussionmentioning

confidence: 99%

A combination of laparoscopy and bilateral uterine artery occlusion for the treatment of type II cesarean scar pregnancy: a retrospective analysis

Wang,

Xue,

Wang

2024

J Int Med Res

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“…Recently, Kathopoulis et al shared their experience with laparoscopic management of two cases utilizing different operative techniques. While the authors conclude that the laparoscopic approach appears to be a safe and effective technique for the management of CSP, applied either as a primary intervention or after failure of medical management, they consider laparoscopic removal of CSP as mandatory when the scar gestation is growing towards the bladder and abdominal cavity (type II CSP) [37]. Laparoscopic excision of CSP up to 11 weeks of gestation has also been reported [38,39].…”

Section: Discussionmentioning

confidence: 99%

Caesarean Scar Pregnancy: A Case Report and a Literature Review

Valasoulis

Magaliou²,

Koufidis³

et al. 2022

Medicina

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Background and Objectives: Caesarean scar pregnancy (CSP) refers to placental implantation on or in the scar of a previous caesarean section and represents a potentially life-threatening condition. CSP is considered a diagnostic challenge in obstetrics, with the diagnosis relying mainly on transvaginal ultrasound (TVS) and the management depending upon case presentation and available healthcare infrastructures. Case Presentation: We present a case of 34-year-old G3P2 with a history of two-previous caesarean sections referred to the outpatient gynaecology clinic of our Department at the 7th week (7/40) of gestation with abnormal early pregnancy TVS findings, illustrating the gestational sac attached to the caesarean scar and a foetal pole with evidence of foetal cardiac activity. We discuss the outcome of an alternative combined medical and surgical approach we followed as well as an updated review of the current literature. Conclusions: The ideal management of CSP requires tertiary centers, equipment availability and experienced healthcare professionals capable of dealing with any possible complication, as well as individualized treatment based on each case presentation.

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“…Many conditions that were previously treated via laparotomy are now treated with minimally invasive surgery 13 . With the appropriate skillset, laparoscopy is considered the preferred route even in potentially life‐threatening conditions such as ruptured ectopic pregnancies 17,18 and cesarean scar pregnancies 19–24 . Segal et al recently reported seven cases of laparoscopic repair of postpartum‐diagnosed uterine rupture 11 .…”

Section: Discussionmentioning

confidence: 99%

Repair of uterine rupture following vaginal delivery: A comparison between minimally invasive and open repair

Stern

Lessans

Shveiky

et al. 2022

Intl J Gynecology & Obste

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Objective To compare operative data and patient satisfaction between open and laparoscopic surgery for postpartum‐diagnosed uterine rupture. Methods In this questionnaire‐based cohort study, the authors collected all cases of postpartum‐diagnosed uterine rupture after vaginal delivery between 2016 and 2020 in a single academic tertiary center. The cohort was divided according to surgical method of repair, and demographic, clinical, operative and postoperative data were collected and compared between groups. A phone questionnaire on various satisfaction domains was conducted and satisfaction rates were compared between groups. Results Eight cases of uterine rupture following vaginal delivery were treated by laparoscopy and eight were treated by laparotomy. The median operative time was 103 min (interquartile range [IQR], 86.3–129.0 min) for the laparoscopy group and 61 min (IQR, 59.0–75.0 min) for the laparotomy group (P = 0.04). Blood transfusion was required in 25% of women who underwent laparoscopy, as compared with 88% of women who underwent laparotomy (P = 0.01 < 0.05). Median hospitalization time was 3 days (IQR, 3–4 days) in the laparoscopy group and 4 days (IQR, 4–4 days) in the laparotomy group (P = 0.2). Overall satisfaction, satisfaction from recovery, satisfaction from scars, satisfaction from ability to care for the neonate, and postoperative pain and mood were all improved in the laparoscopy group, as compared with the laparotomy group. Conclusion Minimally invasive surgery is a viable surgical option for patients with uterine rupture diagnosed after vaginal delivery and may result in better patient recovery and satisfaction.

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Laparoscopic management of cesarean scar pregnancy: Report of two cases with video-presentation of different operative techniques and literature review

Cited by 11 publications

References 49 publications

A combination of laparoscopy and bilateral uterine artery occlusion for the treatment of type II cesarean scar pregnancy: a retrospective analysis

A combination of laparoscopy and bilateral uterine artery occlusion for the treatment of type II cesarean scar pregnancy: a retrospective analysis

Caesarean Scar Pregnancy: A Case Report and a Literature Review

Repair of uterine rupture following vaginal delivery: A comparison between minimally invasive and open repair

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