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标准化阴道骶棘韧带固定术对住院医师而言是一种安全的教学手术吗?

Is standardised vaginal sacrospinous ligament fixation a safe teaching procedure for residents?

作者信息

Sauerwald Axel, Bruns Inke, Peveling Barbara, Brunke Hendrik, Wolff Friedrich

机构信息

Frauenklinik Holweide, Kliniken der Stadt Köln gGbmH, Neufelder Str 32, 51067 Cologne, Germany.

出版信息

Int Urogynecol J. 2011 Mar;22(3):293-8. doi: 10.1007/s00192-010-1341-8. Epub 2010 Dec 10.

DOI:10.1007/s00192-010-1341-8
PMID:21153470
Abstract

INTRODUCTION AND HYPOTHESIS

Several modifications of sacrospinous ligament fixation (SLF) are described.

METHODS

This study presents a standardised SLF technique. Perioperative course and outcome are compared retrospectively after surgery is performed by experienced surgeons or by residents.

RESULTS

Two hundred three SLF were analysed. Eight residents (LO) operated on 41 patients (5.1 ± 2.2). Six experienced surgeons (SO) operated on 162 patients (27.0 ± 25.7). Mean operating time was 67 ± 33 min. (LO 99 ± 45 min vs. SO 59 ± 22 min, p < 0.05). The overall morbidity rate was 7.8%. There was no significant difference regarding complications and outcomes between SO and LO.

CONCLUSIONS

Operation time was longer but outcomes were identical, and morbidity rate was not increased in the group of resident surgeons. In comparison to literature, complication rate was low. SLF should be part of residency programmes.

摘要

引言与假设

已描述了几种骶棘韧带固定术(SLF)的改良方法。

方法

本研究介绍了一种标准化的SLF技术。由经验丰富的外科医生或住院医师进行手术后,对围手术期过程和结果进行回顾性比较。

结果

分析了203例SLF手术。8名住院医师(LO)为41例患者实施了手术(5.1±2.2)。6名经验丰富的外科医生(SO)为162例患者实施了手术(27.0±25.7)。平均手术时间为67±33分钟。(住院医师组99±45分钟,经验丰富的外科医生组59±22分钟,p<0.05)。总体发病率为7.8%。经验丰富的外科医生组和住院医师组在并发症和结果方面无显著差异。

结论

住院医师组的手术时间较长,但结果相同,且发病率未增加。与文献相比,并发症发生率较低。SLF应成为住院医师培训项目的一部分。

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本文引用的文献

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Surgical management of pelvic organ prolapse in women.女性盆腔器官脱垂的外科治疗
Cochrane Database Syst Rev. 2010 Apr 14(4):CD004014. doi: 10.1002/14651858.CD004014.pub4.
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Perioperative outcomes of the Prolift pelvic floor repair systems following introduction to a urogynecology teaching service.将普罗力夫盆底修复系统引入泌尿妇科教学服务后的围手术期结果
Int Urogynecol J Pelvic Floor Dysfunct. 2008 Dec;19(12):1617-22. doi: 10.1007/s00192-008-0704-x. Epub 2008 Aug 19.
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Adjuvant materials in anterior vaginal wall prolapse surgery: a systematic review of effectiveness and complications.
阴道前壁脱垂手术中的辅助材料:有效性和并发症的系统评价
Int Urogynecol J Pelvic Floor Dysfunct. 2008 Dec;19(12):1697-706. doi: 10.1007/s00192-008-0668-x. Epub 2008 Jul 8.
4
A randomised controlled trial evaluating the use of polyglactin mesh, polydioxanone and polyglactin sutures for pelvic organ prolapse surgery.一项评估聚乙醇酸网片、聚二氧六环酮和聚乙醇酸缝线在盆腔器官脱垂手术中应用的随机对照试验。
J Obstet Gynaecol. 2008 May;28(4):427-31. doi: 10.1080/01443610802150077.
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Suture erosion rates and long-term surgical outcomes in patients undergoing sacrospinous ligament suspension with braided polyester suture.接受编织聚酯缝线骶棘韧带悬吊术患者的缝线侵蚀率及长期手术效果
Am J Obstet Gynecol. 2008 May;198(5):600.e1-4. doi: 10.1016/j.ajog.2008.02.049.
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Serious complication 1 year after sacrospinous ligament fixation.
Int Urogynecol J Pelvic Floor Dysfunct. 2008 Sep;19(9):1311-3. doi: 10.1007/s00192-008-0599-6. Epub 2008 Apr 10.
7
Long-term follow-up after vaginal sacrospinous fixation: patient satisfaction, anatomical results and quality of life.阴道骶棘肌固定术后的长期随访:患者满意度、解剖学结果及生活质量
Int Urogynecol J Pelvic Floor Dysfunct. 2008 Jul;19(7):965-9. doi: 10.1007/s00192-008-0563-5. Epub 2008 Feb 2.
8
Complications of three sacrospinous ligament fixation techniques.三种骶棘韧带固定技术的并发症
Int J Gynaecol Obstet. 2007 Oct;99(1):18-22. doi: 10.1016/j.ijgo.2007.04.028. Epub 2007 May 24.
9
Using Veronikis ligature carrier to simplify transvaginal sacrospinous colpopexy.使用韦罗尼基斯结扎带载体简化经阴道骶棘韧带固定术。
Acta Obstet Gynecol Scand. 2006;85(6):721-5. doi: 10.1080/0001634060067214.
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Perioperative complications in abdominal sacrocolpopexy and vaginal sacrospinous ligament fixation procedures.腹式骶骨阴道固定术和阴道骶棘韧带固定术的围手术期并发症
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