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使用马森·勒西持针器进行骶棘韧带阴道固定术。

Sacrospinous colpopexy using Masson luethy needle holder.

作者信息

Ibrahim Ahmed, Eltohamy Osama, Ibrahim Moustafa, Ellaithy Mohamed I, Bahaa Ahmed, Elkady Mohamed, Samaha Ihab

机构信息

Obstetrics and Gynecology Department, Faculty of Medicine, Ain-shams University Maternity Hospital, Cairo, Egypt.

Obstetrics and Gynecology Department, Faculty of Medicine, Ain-shams University Maternity Hospital, Cairo, Egypt.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2014 Aug;179:5-10. doi: 10.1016/j.ejogrb.2014.04.035. Epub 2014 May 6.

Abstract

OBJECTIVE

Sacrospinous colpopexy (SSC) is a well-known surgical technique to correct apical support defect, however its approach is still challenging. The current study describes an alternative and economic approach for suture placement in the sacrospinous ligament during SSC using Masson luethy needle holder.

STUDY DESIGN

A prospective study was conducted in a tertiary care center. The study recruited women with uterovaginal prolapse or post hysterectomy vaginal vault prolapse scheduled for SSC as a constructive surgery for vaginal superior segment defect. Eligible women were assigned to have SSC using Masson luethy needle holder (Group I) for suture placement in the sacrospinous ligament. The control group (Group II) consisted of a group of patients who had SSC using Deschamps ligature carrier.

RESULTS

By the end of the study, 104 women underwent SSC. (Group I) included 55 women while (Group II) included 49 women. The mean SSC operative time was significantly shorter in (Group I) [109±33min versus 206±67min in (Group II), p<0001], with a mean difference of 10.5min [95% CI, 74-136]. This difference in SSC operative time was due to faster suture placement in (Group I) [47±14min versus 153±46min in (Group II), p<0001]. The mean SSC related operative blood loss was significantly less in (Group I) [582±349ml versus 985±463ml in (Group II), p<0001]. The perioperative complications, recurrence and cure rates were similar in both groups.

CONCLUSION

Using Masson luethy needle holder reduced the difficulty associated with suture placement during SSC and allowed the completion of the procedure within a significantly shorter time.

摘要

目的

骶棘韧带固定术(SSC)是一种治疗顶端支持缺陷的知名手术技术,但其操作方法仍具有挑战性。本研究描述了一种在骶棘韧带固定术中使用马森·吕西持针器进行缝线置入的替代且经济的方法。

研究设计

在一家三级医疗中心进行了一项前瞻性研究。该研究招募了计划接受骶棘韧带固定术作为阴道上段缺陷的结构性手术的子宫阴道脱垂或子宫切除术后阴道穹窿脱垂的女性。符合条件的女性被分配使用马森·吕西持针器进行骶棘韧带固定术(第一组)以在骶棘韧带中置入缝线。对照组(第二组)由一组使用德尚结扎器进行骶棘韧带固定术的患者组成。

结果

在研究结束时,104名女性接受了骶棘韧带固定术。第一组包括55名女性,第二组包括49名女性。第一组的骶棘韧带固定术平均手术时间显著更短[109±33分钟对第二组的206±67分钟,p<0.001],平均差异为105分钟[95%CI,74 - 136]。骶棘韧带固定术手术时间的这种差异是由于第一组缝线置入更快[47±14分钟对第二组的153±46分钟,p<0.001]。第一组的骶棘韧带固定术相关手术平均失血量显著更少[582±349毫升对第二组的985±463毫升,p<0.001]。两组的围手术期并发症、复发率和治愈率相似。

结论

使用马森·吕西持针器降低了骶棘韧带固定术中缝线置入的难度,并能在显著更短的时间内完成手术。

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