Comparison of the clinical effect between extraperitoneal and transperitoneal cesarean sections in non⁃infected cases

HU Min; MAO Sisi; LUO Xinyi; LI Qiannan; YANG Qing; WAN Xing

doi:10.14188/j.1671-8852.2022.0110

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Comparison of the clinical effect between extraperitoneal and transperitoneal cesarean sections in non⁃infected cases

更新时间：2026-11-05

- Comparison of the clinical effect between extraperitoneal and transperitoneal cesarean sections in non⁃infected cases
- Medical Journal of Wuhan University Vol. 46, Issue 4, Pages: 500-504(2025)
- 作者机构：
  
  1.武汉大学人民医院妇产科湖北武汉 430060
  2.武汉大学第一临床学院湖北武汉 430060
  3.武汉大学人民医院麻醉科湖北武汉 430060
- 作者简介：
- 基金信息：
- DOI：10.14188/j.1671-8852.2022.0110
  CLC： R719.8
- Received：24 December 2022，
  
  Published：25 April 2025
- 稿件说明：
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胡敏,毛思思,罗心仪等.非感染病例腹膜外与腹膜内剖宫产两种术式临床效果比较[J].武汉大学学报（医学版）,2025,46(04):500-504.

HU Min,MAO Sisi,LUO Xinyi,et al.Comparison of the clinical effect between extraperitoneal and transperitoneal cesarean sections in non⁃infected cases[J].Medical Journal of Wuhan University,2025,46(04):500-504.
胡敏,毛思思,罗心仪等.非感染病例腹膜外与腹膜内剖宫产两种术式临床效果比较[J].武汉大学学报（医学版）,2025,46(04):500-504. DOI： 10.14188/j.1671-8852.2022.0110.

HU Min,MAO Sisi,LUO Xinyi,et al.Comparison of the clinical effect between extraperitoneal and transperitoneal cesarean sections in non⁃infected cases[J].Medical Journal of Wuhan University,2025,46(04):500-504. DOI： 10.14188/j.1671-8852.2022.0110.

摘要

目的

探讨腹膜外与腹膜内剖宫产在非感染病例中的临床效果。

方法

回顾性分析55例非感染病例行剖宫产终止妊娠者，腹膜外剖宫产28例，腹膜内剖宫产27例，比较两组患者切皮至胎儿娩出时间、手术总时间、术中出血量、术后住院时间、胎儿体质量、Apgar 1 min及5 min评分、强效宫缩药物的使用（卡贝缩宫素及卡前列腺素氨丁三醇）、手术前后的血红蛋白（Hb）差值及红细胞压积（HCT）差值、术后排气时间、止痛药使用、伤口愈合不良、术中损伤中的指标。

结果

切皮至胎儿娩出时间、手术总时间、术中出血量、术后住院时间、胎儿体质量、Apgar 1 min及5 min评分、较强宫缩药物的使用、手术前后的Hb差值及HCT差值、止痛药使用、伤口愈合不良和术中损伤的指标，两组比较差异均无统计学意义（

0.05）。腹膜外剖宫产组的术后排气时间短于腹膜内剖宫产组[（19.86±13.33) h

(27.64±14.15) h

]

，差异具有统计学意义（

=0.024）。

结论

在非感染病例中，腹膜外剖宫产与腹膜内剖宫产相比，并不增加术中出血、新生儿窘迫及手术创伤的情况，也不增加手术总时间，并可应用于需紧急终止妊娠娩出胎儿的情况，术后恢复更快，值得推广应用。

Abstract

Objective

To compare the clinical effect of extraperitoneal and intraperitoneal cesarean sections in non⁃infected cases.

Methods

A total of 55 cases of non⁃infected cases who needed termination of gestation by surgery in Renmin Hospital of Wuhan University from January 2019 to January 2020 were retrospectively analyzed and divided into extraperitoneal cesarean section group (

=28) and transperitoneal cesarean section group (

=27). Clinical statistics were compared between the two groups

including the time from the beginning of cutting skin to childbirth

total time of operation

intraoperative blood loss

postoperative hospitalization time

fetal weight

and 1 min and 5 min Apgar scores

application of uterotonic agents

changes of hemoglobin (Hb) and hematocrit (HCT) after operation

postoperative anal exhaust time

postoperative pain

poor wound healing

and intraoperative injuries.

Results

No statistical difference was found in the time from the beginning of cutting skin to

childbirth

total time of operation

intraoperative blood loss

postoperative hospitalization time

fetal weight

and 1 min and 5 min Apgar scores

application of uterotonic agents

changes of Hb and HCT after operation

postoperative pain

poor wound healing cases

and intraoperative injury (

0.05) between the two groups. While the postoperative anal exhaust time in the extraperitoneal caesarean section group was shorter than that in the transperitoneal caesarean section group at (19.86±13.33) h

(27.64±14.15) h

and the difference was statistically significant (

=0.024).

Conclusion

Compared with intraperitoneal cesarean section in non⁃infected cases

extraperitoneal cesarean section does not increase intraoperative bleeding

neonatal distress

and surgical trauma

nor does it increase the total operative time. It also can be applied to the situation of emergency termination of pregnancy and delivery of the fetus

and the postoperative recovery is also quick

which is worthy of clinical application.

关键词

Keywords

references

TAPPAUF C , SCHEST E , REIF P , et al . Extraperitoneal versus transperitoneal cesarean section: A prospective randomized comparison of surgical morbidity [J ] . Am J Obstet Gynecol , 2013 , 209 ( 4 ): 338 .e 1 ⁃ 338 .e8.

YAPCA O E , TOPDAGI Y E , AL R A . Fetus delivery time in extraperitoneal versus transperitoneal cesarean section: A randomized trial [J ] . J Matern Fetal Neonatal Med , 2020 , 33 ( 4 ): 657 ⁃ 663 .

HANSON H B . Current use of the extraperitoneal cesarean section: A decade of experience [J ] . Am J Obstet Gynecol , 1984 , 149 ( 1 ): 31 ⁃ 34 .

SHINDE G , PAWAR A , JADHAV B , et al . Modified extraperitoneal Caesarean section: Clinical experience [J ] . Trop Doct , 2012 , 42 ( 4 ): 188 ⁃ 190 .

JOSCHKO R . Comparison of the intra⁃ and postoperative course in 254 extraperitoneal and 102 intraperitoneal cesarean sections [J ] . Zentralbl Gynakol , 1974 , 96 ( 49 ): 1553 ⁃ 1562 .

EICHNER E , ROTH A , REITMAN H , et al . Bladder avulsion as a complication of extraperitoneal cesarean section: A case report [J ] . Am J Obstet Gynecol , 1954 , 68 ( 4 ): 1191 ⁃ 1194 .

CHOU C Y , LIANG P C , CHEN C A , et al . Cervical abscess with vaginal fistula after extraperitoneal Cesarean section [J ] . J Formos Med Assoc , 2007 , 106 ( 12 ): 1048 ⁃ 1051 .

STANSFIELD F R , DRABBLE L W D . An assessment of extraperitoneal Caesarean section [J ] . Lancet , 1951 , 1 ( 6646 ): 74 ⁃ 76 .

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