盆腔器官脱垂患者腹腔镜骶骨阴道会阴固定术前及术后的肛肠症状
Anorectal symptoms before and after laparoscopic sacrocolpoperineopexy for pelvic organ prolapse.
作者信息
Ramanah Rajeev, Ballester Marcos, Chereau Elisabeth, Bui Charles, Rouzier Roman, Daraï Emile
机构信息
Obstetrics and Gynecology Department, Tenon Hospital, University Pierre et Marie Curie, Paris, France.
出版信息
Int Urogynecol J. 2012 Jun;23(6):779-83. doi: 10.1007/s00192-011-1657-z. Epub 2012 Jan 19.
INTRODUCTION AND HYPOTHESIS
To evaluate changes in anorectal symptoms before and after pelvic organ prolapse (POP) surgery, using laparoscopic sacrocolpoperineopexy.
METHODS
Preoperative and postoperative anorectal symptoms, colorectal-anal distress inventory (CRADI) and colorectal-anal impact questionnaire (CRAIQ) scores were prospectively compared from 90 consecutive women undergoing laparoscopic sacrocolpoperineopexy.
RESULTS
After a median follow-up of 30.7 months, laparoscopic surgery significantly worsened CRADI (p = 0.02) with no effect on CRAIQ (p = 0.37) scores. Post-operative and de novo straining (27%) and the need for digital assistance (17%) were the most frequent anorectal symptoms. No correlation was found between laparoscopic surgery and anorectal symptoms after multivariate analysis (OR = 2.45[95% confidence interval 0.99-6.05], p = 0.05).
CONCLUSION
Anorectal symptoms are not improved after POP surgery by laparoscopic sacrocolpoperineopexy.
引言与假设
采用腹腔镜骶骨阴道会阴固定术评估盆腔器官脱垂（POP）手术前后的肛肠症状变化。
方法
对连续90例行腹腔镜骶骨阴道会阴固定术的女性患者，前瞻性比较其术前和术后的肛肠症状、结直肠-肛门不适量表（CRADI）及结直肠-肛门影响问卷（CRAIQ）评分。
结果
中位随访30.7个月后，腹腔镜手术使CRADI显著恶化（p = 0.02），对CRAIQ评分无影响（p = 0.37）。术后新发用力排便（27%）和需要手指辅助排便（17%）是最常见的肛肠症状。多因素分析显示腹腔镜手术与肛肠症状之间无相关性（比值比=2.45[95%置信区间0.99 - 6.05]，p = 0.05）。
结论
腹腔镜骶骨阴道会阴固定术治疗POP后，肛肠症状未得到改善。
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