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To explore the safety and efficiency of transvaginal surgical treatment of cesarean scar pregnancy (CSP).A retrospective analysis of 54 CSP patients that received treatment in our hospital from October 2011 to September 2015 was performed, dividing two groups: Group A (n=34) received transvaginal cesarean scar pregnancy focus clearance surgery while Group B (n=20) received transcervical resection following methotrexate/mifepristone-combined treatment. The basic clinical findings were collected and analyzed, along with the curative effects between the two groups.Differences in age (30.91 ± 4.59 years vs. 31.91 ± 5.53 years) for gravidity (2.97 ± 1.24 times vs. 2.75 ± 1.48 times), cesarean section (1.24 ± 0.43 vs. 1.20 ± 0.41), time interval from last cesarean section (56.53 ± 32.93 months vs. 58.70 ± 39.44 months), menelipsis (51.35 ± 10.90 days vs. 57.85 ± 16.62 days), pre-operative serum-hCG (27953.65 ± 37517.10 mIU/L vs. 17368.24 ± 35094.14 mIU/L), operation time (43.34 ± 12.38 min vs 40.07 ± 16.88 min), menstruation recovery time (1.23 ± 0.53 months vs. 1.55 ± 0.76 months) were not statistically significant (p0.05). The differences in the intraoperative blood loss (43.34 ± 12.38 ml vs. 40.07 ± 16.88 ml), average hospital stay (7.61 ± 2.47 days vs. 12.42 ± 3.64 days), time for β-hCG to return to normal (18.50 ± 8.19 mIU/L vs. 29.00 ± 12.96 mIU/L) between the two groups were statistically significant (p0.05). Group A was significantly lower than Group B.Transvaginal surgery is an effective and relatively safe treatment option for CSP patients.

The findings from dissections, injection studies, and angiograms of 180 specimens of the anterior portion of left and right iliac crests taken from 90 cadavers are reported. These findings suggested that the deep circumflex iliac vessels were suitable for use as a nutritive pedicle in microvascular free transfer of iliac bone. Therefore, the technique of microvascular free transfer of iliac bone based on these vessels was developed and applied clinically in 2 cases with good results. The advantages and disadvantages of using the superficial circumflex iliac vessels or the deep circumflex iliac vessels as the vascular pedicle for iliac grafts also are discussed.

The findings from dissection, injection studies, corrosion specimens, and angiograms in 300 specimens of the iliogluteal region taken from 150 cadavers are reported. These findings suggest that the deep superior branches of the superior gluteal vessels may serve a nutritive pedicle in microvascular free transfer of iliac bone. Therefore, the operative technique has been developed and applied clinically with good results. The selection of different vessels as a nutritive pedicle for the free transfer of iliac bone is discussed.