Lin Lawrence L, Phelps John Y, Liu C Y
Chattanooga Women's Laser Center, Chattanooga, Tennessee 37421, USA.
J Minim Invasive Gynecol. 2005 May-Jun;12(3):216-20. doi: 10.1016/j.jmig.2005.03.014.
The objective of our study was to describe the surgical technique of laparoscopic vaginal vault suspension using the uterosacral ligaments. In addition, we performed a retrospective analysis of this laparoscopic technique on 133 patients with advanced symptomatic vaginal vault prolapse to evaluate the efficacy and durability of this laparoscopic technique. Efficacy and anatomic outcome were assessed by the Baden-Walker halfway scoring system before and after the surgical procedure. Preoperatively, all patients showed evidence of grade 2 or greater prolapse (descent to the level of the hymen). Fifty-one patients (38.4%) had uterovaginal prolapse, and 82 patients (61.6%) had vaginal vault prolapse. The patients were reevaluated at 1, 6, and 12 months postoperatively and yearly thereafter. The postoperative follow-up ranged from 2.0 to 7.3 years. Postoperatively, 116 patients (87.2%) had no recurrence of prolapse, and 17 patients (12.8%) had recurrence of prolapse. The major complication rate was 2.25%. We conclude that laparoscopic vaginal vault suspension is a safe, efficacious, and durable alternative for the management of vaginal vault prolapse.
我们研究的目的是描述使用子宫骶韧带进行腹腔镜阴道穹窿悬吊术的手术技术。此外，我们对133例有症状的晚期阴道穹窿脱垂患者的这种腹腔镜技术进行了回顾性分析，以评估该腹腔镜技术的疗效和持久性。通过Baden-Walker半程评分系统在手术前后评估疗效和解剖学结果。术前，所有患者均有2级或更高级别的脱垂证据（下降至处女膜水平）。51例患者（38.4%）有子宫阴道脱垂，82例患者（61.6%）有阴道穹窿脱垂。术后1、6和12个月以及此后每年对患者进行重新评估。术后随访时间为2.0至7.3年。术后，116例患者（87.2%）脱垂未复发，17例患者（12.8%）脱垂复发。主要并发症发生率为2.25%。我们得出结论，腹腔镜阴道穹窿悬吊术是治疗阴道穹窿脱垂的一种安全、有效且持久的替代方法。
