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\begin{document}

\title{Laparoscopy or laparotomy for high risk caesarean scar pregnancy?a
retrospective study}



\author[1]{Ronghua  Liu}%
\author[1]{Ting Zhou}%
\author[1]{Pengfei Cui}%
\author[1]{wenwen wang}%
\author[1]{SHIXUAN WANG}%
\affil[1]{Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology}%


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  \date{May 15, 2024}


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\begin{abstract}
Objective The aim of this study was to compare the outcomes of with
laparotomy or laparoscopy in the treatment of high-risk CSP and evalute
the optimal treatment measure about it. Design A retrospective study.
Setting Tongji Hospital. Population 278 patients with caesarean scar
pregnancy between 2013 and 2018. Methods We compared and analysed the
characteristics of the laparoscopic and open surgeries in the treatment
of high-risk CSP and the advantages and disadvantages of different
methods of vascular pretreatment. We also systematically evaluated CSP
patients undergoing laparoscopic or laparotomic surgery. Results
Intraoperative bleeding, transfusion rate, total days of hospitalization
and postoperative hospital stay were better in laparoscopy than in
laparotomy (p\textless{}0.05). There was no difference in the factors
(\selectlanguage{greek}β-\selectlanguage{english}HCG decrease, reoperation and tissue residues) closely related to the
success of the surgery in the two groups. Furthermore, we pretreated
blood vessels differently before the operation. Tissue residue,
reoperation and intraoperative blood transfusion rates in patients with
temporary vascular occlusion were better than in patients with permanent
vascular occlusion. As of the latest English literature, the systematic
review results showed that most of the current studies on CSP are case
reports and retrospective analyses (67.74\% and 29.03\%, respectively),
and the sample sizes of these retrospective studies are very small.
Conclusions This study revealed that laparoscopic surgery is superior to
laparotomic surgery in the treatment of high-risk CSP. Patients
benefited from temporary arterial occlusion in both groups. Temporary
arterial occlusion under laparoscopic surgery may be the best treatment
for high-risk CSP.%
\end{abstract}%



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