Jeon Myung Jae, Bai Sang Wook
Department of Obstetrics and Gynecology, Yonsei University College of Medicine, 134 Sinchon-Dong, Seodaemun-Gu, Seoul, Korea.
Yonsei Med J. 2007 Apr 30;48(2):147-56. doi: 10.3349/ymj.2007.48.2.147.
There has been growing interest in the use of grafts in pelvic reconstructive surgery. This article will address available graft materials and assess their clinical efficacy and safety. We conducted a Pubmed MEDLINE literature search for full-length English text studies with follow-up periods of at least one year. There are many reports on synthetic and biological graft materials; the majority are not well-designed, have short-term follow-up, small sample sizes, and poor outcome assessment. The use of non-absorbable synthetic grafts may offer excellent anatomical cure rates. However, it is associated with a high incidence of graft-related complications, including healing abnormalities and adverse bladder, bowel, and sexual function effects. These complications can be decreased with absorbable synthetic meshes, but efficacy is lower compared to non-absorbable ones. There is insufficient evidence in favor of biological grafts. In conclusion, based on current knowledge, routine application of grafts in pelvic reconstruction is not recommended. It is preferred that graft utilization be individualized, with close monitoring for complications.
骨盆重建手术中移植物的应用越来越受到关注。本文将探讨可用的移植物材料，并评估其临床疗效和安全性。我们在Pubmed MEDLINE数据库中进行了文献检索，查找随访期至少为一年的英文全文研究。关于合成和生物移植物材料有许多报道；大多数研究设计不佳、随访期短、样本量小且结局评估较差。不可吸收合成移植物的使用可能具有出色的解剖学治愈率。然而，它与移植物相关并发症的高发生率相关，包括愈合异常以及对膀胱、肠道和性功能的不良影响。使用可吸收合成网片可减少这些并发症，但与不可吸收网片相比疗效较低。支持生物移植物的证据不足。总之，基于目前的知识，不建议在骨盆重建中常规应用移植物。最好根据个体情况使用移植物，并密切监测并发症。
