Hsiao Kenneth C, Latchamsetty Kalyan, Govier Fred E, Kozlowski Paul, Kobashi Kathleen C
Department of Urology, Virginia Mason Medical Center, Seattle, Washington, USA.
J Endourol. 2007 Aug;21(8):926-30. doi: 10.1089/end.2006.0381.
Laparoscopic sacrocolpopexy (LSCP) offers a minimally invasive treatment for vaginal vault prolapse. We describe the surgical technique and offer insight into the learning curve. In addition, we performed a case series review comparing the laparoscopic procedure with its open surgical counterpart with respect to various demographic and perioperative parameters.
The Institutional Review Board-approved continence database at our institution was queried to identify all patients undergoing sacrocolpopexy between August 1999 and October 2004. The LSCP was performed in 25 patients, and open abdominal sacrocolpopexy (ASCP) was performed in 22 patients. Data were analyzed using Student's t-test and the Fisher exact test.
No significant difference was observed in the demographic characteristics of the patients undergoing the two approaches. The mean estimated blood loss (P = 0.0002) and mean length of hospitalization (P < 0.0001) were significantly less for LSCP, whereas the operative time was significantly longer (219.9 minutes v 185.2 minutes; P = 0.045). The success rate for LSCP at 5.9 months was 100%; the ASCP success rate at 11.0 months was 95%.
Laparoscopic sacrocolpopexy led to shorter hospitalization, better hemostasis, and less pain than the open procedure. Early follow-up suggests that LSCP is as effective as ASCP for the treatment of vaginal vault prolapse.
腹腔镜骶骨阴道固定术（LSCP）为阴道穹窿脱垂提供了一种微创治疗方法。我们描述了该手术技术，并深入探讨了学习曲线。此外，我们进行了一项病例系列回顾，比较了腹腔镜手术与其开放手术对应方式在各种人口统计学和围手术期参数方面的差异。
查询了我们机构经机构审查委员会批准的尿失禁数据库，以确定1999年8月至2004年10月期间所有接受骶骨阴道固定术的患者。25例患者接受了LSCP，22例患者接受了开放腹部骶骨阴道固定术（ASCP）。使用学生t检验和Fisher精确检验分析数据。
接受两种手术方式的患者在人口统计学特征方面未观察到显著差异。LSCP的平均估计失血量（P = 0.0002）和平均住院时间（P < 0.0001）显著更少，而手术时间显著更长（219.9分钟对185.2分钟；P = 0.045）。LSCP在5.9个月时的成功率为100%；ASCP在11.0个月时的成功率为95%。
与开放手术相比，腹腔镜骶骨阴道固定术导致住院时间更短、止血效果更好且疼痛更少。早期随访表明，LSCP在治疗阴道穹窿脱垂方面与ASCP一样有效。
