EARLY HISTOPATHOLOGICAL COMPARISON OF SINGLE VERSUS DOUBLE-LAYER CLOSURE OF UTERINE INCISION DURING CESAREAN: A CONTROLLED STUDY IN RATS

Abstract

Objective: Long-term complications of cesarean delivery are numerous and are increasing due to the high cesarean rate. The long-term complications are attributed to the different suturing methods. The single-layer locked (SLL) and double-layerunlocked (DLU) are the most compared. This study aims to compare the early histopathological properties of these two suture techniques in an experimental animal study. Material and Method: Ten pregnant Wistar-Albino rats had cesarean at term. The right uterine horns were repaired using the SLL suture technique, and the left ones were repaired using the DLU technique. The control subjects were the six uterine horns of three pregnant rats delivered vaginally. Each animal underwent a hysterectomy on day 15 of pregnancy, and each uterus was an experimental unit. The mean thickness of the endometrium and myometrium of the intervention groups with histopathological features and controls were compared. Result: In SLL and DLU groups, the endometrium (276.6±123.1vs. 258.4±125.9 μm; p=0.748) and myometrium (531.7±189.2 vs. 505.9±182.1 μm; p=0.612) in scarred areas were similar. In nonscarred areas, the endometrium was measured as 239.9±68.9, 256.5±127.2, and 316.4±98.6 μm in SLL, DLU, and control group, respectively (p=0.347). The myometrium of non-scarred areas was also similar in all groups evaluated (387.2±119.9; 364.5±154.1 and 234.0±49.1 μm; p=0.265). The histopathological features of uteri repaired with two different techniques were also similar. Conclusion: The early histopathological properties of all uteri examined were similar after repairing with SLL or DLU techniques. These results indicate that the repair process does not differ in the early stages, regardless of the uterine closure technique used.

Keywords

• Surgical technique
• uterine closure
• cesarean section
• pregnancy
• histopathology

SEZARYEN SIRASINDA UTERUSUN TEK YA DA ÇİFT KAT KAPATILMASININ ERKEN HİSTOPATOLOJİK KARŞILAŞTIRILMASI: RATLARDA KONTROLLÜ ÇALIŞMA

Abstract

Amaç: Sezaryenin birçok uzun dönem komplikasyonu vardır. Yüksek sezaryen oranları nedeniyle bunlar artmaktadır. Uzun dönem komplikasyonların farklı sütür teknikleri ile ilişkisi olduğu düşünülmektedir. Tek kat kilitlenerek (SLL) ve çift kat kilitlenmeden (DLU) en çok karşılaştırılan yöntemlerdir. Bu çalışmanın amacı iki farklı sütür tekniğinin erken dönem histopatolojik sonuçlarını bir deneysel hayvan modelinde karşılaştırmaktır. Gereç ve Yöntem: On Wistar-Albino rata miadında sezaryen yapıldı. Sağ uterus SLL, sol uterus DLU olarak kapatıldı. Kontrol grubunda ise normal doğum yapmış üç ratın altı uterusu bulunmaktaydı. Doğumdan 15 gün sonra tüm hayvanlara histerektomi yapıldı ve her bir uterus deney ünitesi olarak kullanıldı. Çalışma ve kontrol grupları arasında endometrium ve myometrium ortalama kalınlıkları ile histopatolojik özellikler karşılaştırıldı. Bulgular: SLL ve DLU gruplarında endometrium (276,6±123,1 vs. 258,4±125,9 μm; p=0,748) ve myometrium (531,7±189,2 vs. 505,9±182,1 μm; p=0,612) skarlı alanda benzer kalınlığa sahipti. Skarsız alanda SLL, DLU ve kontrol gruplarında endometrium kalınlığı sırasıyla 239,9±68,9; 256,5±127,2, ve 316,4±98,6 μm olarak ölçüldü ve benzer olarak değerlendirildi (p=0,347). Benzer şekilde skar olmayan alanda SLL, DLU ve kontrol gruplarında myometrium kalınlığı da benzerdi (387,2±119,9; 364,5±154,1 ve 234,0±49,1 μm; p=0,265). İki farklı teknikle kapatılan uterus örneklerinin histopatolojik özellikleri de benzerdi. Sonuç: SLL ve DLU teknikleri ile uterus kapatıldıktan sonra uterusların erken dönem histopatolojik özellikleri benzer olarak değerlendirildi. Bu sonuçlara göre uterus nasıl kapatılırsa kapatılsın erken dönemde iyileşme sürecinin etkilenmediğine işaret etmektedir.

Keywords

• Cerrahi teknik
• uterusun kapatılması
• sezaryen
• gebelik
• histopatoloji

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