腹骶部子宫固定术：一项比较骶骨子宫固定术与骶骨阴道固定术加子宫切除术的初步研究。
Abdominal sacral hysteropexy: a pilot study comparing sacral hysteropexy to sacral colpopexy with hysterectomy.
作者信息
Cvach Kristina, Geoffrion Roxana, Cundiff Geoffrey W
机构信息
Department of Urogynecology, Mercy Hospital for Women, Melbourne, Australia.
出版信息
Female Pelvic Med Reconstr Surg. 2012 Sep-Oct;18(5):286-90. doi: 10.1097/SPV.0b013e3182673772.
OBJECTIVES
Treatment of pelvic prolapse with uterine conservation using the sacral hysteropexy may be associated with less patient morbidity but has uncertain subjective and objective outcomes. We sought to compare abdominal sacral hysteropexy (ASH) with sacral colpopexy/total abdominal hysterectomy (ASC/TAH).
METHODS
This is an ambispective (retrospective/prospective) cohort pilot study comparing ASH to ASC/TAH. The primary outcome was global impression of improvement. Secondary outcomes were based on validated quality-of-life questionnaires and surgical complications.
RESULTS
Eighteen ASHs were compared to 9 ASC/TAHs after a mean follow-up of 19 months. Whereas subjective outcomes did not differ, anterior failure (55%) and subsequent uterine pathology (22%) were higher in the ASH cohort. Graft erosion occurred in 33% of the ASC/TAH group.
CONCLUSIONS
The ASH offers advantages and disadvantages that warrant further investigation with a prospective study.
目的
采用骶骨子宫固定术保留子宫治疗盆腔器官脱垂可能会降低患者的发病率，但主观和客观疗效尚不确定。我们试图比较经腹骶骨子宫固定术（ASH）与骶骨阴道固定术/全腹子宫切除术（ASC/TAH）。
方法
这是一项比较ASH与ASC/TAH的双向（回顾性/前瞻性）队列试验性研究。主要结局指标为总体改善印象。次要结局指标基于经过验证的生活质量问卷和手术并发症。
结果
平均随访19个月后，对18例ASH患者与9例ASC/TAH患者进行了比较。虽然主观结局无差异，但ASH队列中的前壁脱垂失败率（55%）和随后的子宫病变发生率（22%）更高。ASC/TAH组中移植物侵蚀发生率为33%。
结论
ASH有其优缺点，值得通过前瞻性研究作进一步调查。
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