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高位子宫骶韧带阴道穹窿悬吊术:可吸收缝线与永久性缝线用于顶端固定的比较

High uterosacral ligament vaginal vault suspension: comparison of absorbable vs. permanent suture for apical fixation.

作者信息

Kasturi Seshadri, Bentley-Taylor Miriam, Woodman Patrick J, Terry Colin L, Hale Douglass S

机构信息

Division of Female Pelvic Medicine and Reconstructive Surgery, Deparment of Gynecology and Obstetrics, Indiana University, 1633 North Capitol Ave, Indianapolis, IN 46202, USA.

出版信息

Int Urogynecol J. 2012 Jul;23(7):941-5. doi: 10.1007/s00192-012-1708-0. Epub 2012 Mar 9.

DOI:10.1007/s00192-012-1708-0
PMID:22402640
Abstract

INTRODUCTION AND HYPOTHESIS

The primary objective of this study was to compare outcomes of absorbable and permanent suture for apical support with high uterosacral ligament vaginal vault suspension (HUSLS). The secondary objective was to investigate the rate of suture erosion.

METHODS

This was a retrospective study of patients who underwent HUSLS with delayed absorbable and primarily permanent suture. Apical support was calculated as a new variable: Percent of Perfect Ratio (POP-R). This variable measures apical support as the position of the apex in relation to vaginal length.

RESULTS

At 1-year follow-up, there was no significant difference in apical support between the two groups. The number of patients who suffered from suture erosion in the cohort that received permanent suture was 11 (22%).

CONCLUSIONS

Permanent suture, in comparison with delayed absorbable suture, for HUSLS does not offer significantly better apical support at short-term follow-up. It is also associated with a high rate of suture erosion.

摘要

引言与假设

本研究的主要目的是比较可吸收缝线和永久性缝线在高位骶韧带阴道穹窿悬吊术(HUSLS)中用于顶端支撑的效果。次要目的是调查缝线侵蚀率。

方法

这是一项对接受HUSLS手术且分别使用延迟可吸收缝线和主要使用永久性缝线的患者进行的回顾性研究。顶端支撑被计算为一个新变量:完美比例百分比(POP-R)。该变量通过顶端相对于阴道长度的位置来衡量顶端支撑。

结果

在1年的随访中,两组之间的顶端支撑没有显著差异。接受永久性缝线的队列中发生缝线侵蚀的患者有11例(22%)。

结论

与延迟可吸收缝线相比,在短期随访中,永久性缝线用于HUSLS并没有提供明显更好的顶端支撑。它还与较高的缝线侵蚀率相关。

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Uterosacral ligament vaginal vault suspension using delayed absorbable monofilament suture.使用延迟可吸收单丝缝线进行子宫骶韧带阴道穹窿悬吊术。
Int Urogynecol J. 2011 Nov;22(11):1389-94. doi: 10.1007/s00192-011-1470-8. Epub 2011 Jun 17.
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High levator myorraphy versus uterosacral ligament suspension for vaginal vault fixation: a prospective, randomized study.高位提肌缝合术与子宫骶韧带悬吊术用于阴道穹窿固定的前瞻性随机研究。
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在一家教学机构中,接受永久性编织缝线子宫骶韧带悬吊术的患者出现的缝合并发症。
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Uterosacral ligament vault suspension: five-year outcomes.子宫骶韧带穹窿悬吊术:五年随访结果
Obstet Gynecol. 2006 Aug;108(2):255-63. doi: 10.1097/01.AOG.0000224610.83158.23.
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Posterior culdeplasty; surgical correction of enterocele during vaginal hysterectomy; a preliminary report.后路直肠阴道成形术;阴道子宫切除术中肠膨出的手术矫正;初步报告。
Obstet Gynecol. 1957 Dec;10(6):595-602.
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High uterosacral vaginal vault suspension with fascial reconstruction for vaginal repair of enterocele and vaginal vault prolapse.高位子宫骶骨阴道穹窿悬吊术联合筋膜重建术用于阴道直肠膨出和阴道穹窿脱垂的阴道修复。
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