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盆腔器官脱垂修复术中使用套管针的阴道网片手术的围手术期并发症

Perioperative complications in vaginal mesh procedures using trocar in pelvic organ prolapse repair.

作者信息

Demirci Fuat, Birgul Karakoc, Demirci Oya, Demirci Elif, Akman Yavuz, Karaalp Erhan, Dolgun Nihal

机构信息

Kadikoy Sifa Health Group, Istanbul, Turkey.

Zeynep Kamil Women's Health and Maternity Hospital, Istanbul, Turkey.

出版信息

J Obstet Gynaecol India. 2013 Oct;63(5):328-31. doi: 10.1007/s13224-013-0396-0. Epub 2013 May 15.

Abstract

INTRODUCTION AND HYPOTHESIS

This study aimed to document intraoperative and early postoperative complications associated with the use of vaginal mesh with trocar in pelvic organ prolapse (POP) repair.

METHODS

This is a retrospective review of 120 cases of vaginal repair of POP using vaginal mesh. Of the 120 patients, 31 underwent anterior mesh repair (Light mesh 10, Avaulta 1, Perigee 1, and Prolift 19); 35 underwent posterior mesh repair (Light mesh 2, Posterior IVS 17, and Prolift 16); and 54 underwent anterior and posterior mesh (total) repair (Light mesh 8, Prolift 32, and Prolift M 14).

RESULTS

Three bladder injuries (2.5%) and one distal rectal injury (0.8%) occurred during dissection. Three of four organ injuries (75%) had previous prolapse repair. Overall four patients (3%) required transfusion. Urinary retention exceeding 5 days occurred in four patients. Three of them (60%) also underwent TVT-O. Groin pain occurred in two patients one of whom underwent TVT-O. Gluteal pain occurred in one patient. Early mesh exposure occurred in the vaginal cuff of a patient who underwent hysterectomy.

CONCLUSIONS

The vaginal mesh procedures may be done with relatively few perioperative complications. However, there is a need for more randomized controlled trials with long-term follow-up to clarify its postoperative long-term complications and morbidities.

摘要

引言与假设

本研究旨在记录盆腔器官脱垂(POP)修复术中及术后早期与使用带套管阴道网片相关的并发症。

方法

这是一项对120例使用阴道网片进行POP阴道修复病例的回顾性研究。120例患者中,31例行前路网片修复(轻网片10例、Avaulta 1例、Perigee 1例、Prolift 19例);35例行后路网片修复(轻网片2例、后路IVS 17例、Prolift 16例);54例行前路和后路(全)网片修复(轻网片8例、Prolift 32例、Prolift M 14例)。

结果

解剖过程中发生3例膀胱损伤(2.5%)和1例直肠远端损伤(0.8%)。4例器官损伤中有3例(75%)曾行脱垂修复术。总体4例患者(3%)需要输血。4例患者出现尿潴留超过5天。其中3例(60%)还接受了经闭孔无张力尿道中段吊带术(TVT - O)。2例患者出现腹股沟疼痛,其中1例接受了TVT - O。1例患者出现臀肌疼痛。1例接受子宫切除术患者的阴道断端出现早期网片暴露。

结论

阴道网片手术围手术期并发症可能相对较少。然而,需要更多长期随访的随机对照试验来阐明其术后长期并发症和发病率。

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