Latini Jerilyn M, Brown Jameel A, Kreder Karl J
Department of Urology, University of Iowa Iowa City, Iowa 52242-1089, USA.
J Urol. 2004 Mar;171(3):1176-9. doi: 10.1097/01.ju.0000103925.56765.bc.
Numerous techniques and materials have traditionally been used to correct vaginal vault prolapse, including cadaveric fascia, synthetic materials and autologous rectus fascia. We report our experience with autologous fascia lata used for abdominal sacral colpopexy.
A retrospective review identified all women who underwent abdominal sacral colpopexy using autologous fascia lata for vaginal vault prolapse with at least 18 months of followup. Preoperative and postoperative pelvic organ prolapse quantification (POP-Q) scores, relevant clinical and operative parameters, treatment efficacy, harvest site morbidity and patient satisfaction were assessed.
Ten women underwent this procedure between 1999 and 2001. Mean patient age was 68.3 years (range 55 to 82). Followup was 19 to 42 months (mean +/- SD 30.5 +/- 7.78). Preoperatively POP-Q stages were II to IV in 3, 5 and 2 cases, respectively. Postoperative POP-Q scores improved to and remained at stage II or lower in all 10 patients. Mean operative time was 182 +/- 40.94 minutes (range 136 to 265). Mean blood loss was 107.5 +/- 50.07 cc (range 50 to 200). There was no morbidity associated with fascia lata harvest. Eight of the 9 women alive at review completed and returned the survey. When asked if they could return to how they were before surgery, would they still have the same procedure done and would they recommend the procedure to a friend, all respondents answered yes to each question.
Autologous fascia lata compares favorably in efficacy to that reported for other materials in the contemporary literature and it is not associated with any significant morbidity.
传统上，有多种技术和材料用于纠正阴道穹窿脱垂，包括尸体筋膜、合成材料和自体腹直肌筋膜。我们报告使用自体阔筋膜进行腹骶阴道固定术的经验。
一项回顾性研究确定了所有使用自体阔筋膜进行腹骶阴道固定术治疗阴道穹窿脱垂且随访至少18个月的女性。评估术前和术后盆腔器官脱垂定量（POP-Q）评分、相关临床和手术参数、治疗效果、取材部位的发病率以及患者满意度。
1999年至2001年间，10名女性接受了该手术。患者平均年龄为68.3岁（范围55至82岁）。随访时间为19至42个月（平均±标准差30.5±7.78）。术前POP-Q分期分别为Ⅱ期3例、Ⅲ期5例和Ⅳ期2例。所有10例患者术后POP-Q评分均改善至Ⅱ期或更低并维持在该水平。平均手术时间为182±40.94分钟（范围136至265分钟）。平均失血量为107.5±50.07毫升（范围50至200毫升）。取材阔筋膜未出现并发症。在接受复查的9名存活女性中，8名完成并返回了调查问卷。当被问及她们是否能恢复到手术前的状态、是否仍会选择进行相同的手术以及是否会向朋友推荐该手术时，所有受访者对每个问题均回答“是”。
与当代文献中报道的其他材料相比，自体阔筋膜在疗效方面具有优势，且未出现任何显著的并发症。
