Park Young-Han, Yang Seong Cheon, Park Sung Taek, Park Sung Ho, Kim Hong Bae
1. Department of Obstetrics and Gynecology, Hallym University Sacred Heart Hospital, Hallym University Medical Center (HUMC), Seoul, Korea;
2. Department of Obstetrics and Gynecology, Hankang Sacred Heart Hospital, Hallym University Medical Center (HUMC), Seoul, Korea;
Int J Med Sci. 2014 Aug 10;11(11):1082-8. doi: 10.7150/ijms.9027. eCollection 2014.
Our purpose was to provide the clinical advantages of the laparoscopic approach compare to the vaginal approach in correcting uterine and vaginal vault prolapse.
Between June 2007 and June 2011, 174 women were admitted to HUMC (Hallym University Medical Center) and underwent pelvic reconstructive surgery for prolapsed vaginal vault and uterus. Upon retrospective review of the medical records, 174 of the patients who had symptoms of pelvic organ prolapsed and Baden-Walker prolapse grade ≥ 2 were selected and divided into two groups as follows: vaginal approach group (n=120) and laparoscopic approach group (n=54). We compared the results of clinical outcome by analyzing Student's t-test and χ(2)-test or the Fisher exact test as appropriate.
There were significant difference in success rates without reoperation for recurrence as 91.7% (vaginal approach group, n=110) vs 100% (laparoscopic approach group, n=54), p=0.032. Mean follow-up duration was 31.3 ± 7.6 months for vaginal approach group and 29.7 ± 9.7 months for laparoscopic approach group. The Foley catheter indwelling duration (4.7± 1.9 vs 3.4±2.1 days, p< 0.001) and the length of postoperative hospitalization (6.4 ± 2.1 vs 5.0 ± 1.9 days, p <0.001) were significantly longer in vaginal approach group, whereas the operative time was significantly longer (108.2 ± 38.6 vs 168.3 ± 69.7 minutes, p <0.001) in laparoscopic approach group.
Our result suggest there is significantly lower recurrence rate requiring reoperation and less catheterization time but increased operative time for laparascopic sacrocolpopexy.
我们的目的是比较腹腔镜手术与阴道手术在纠正子宫和阴道穹窿脱垂方面的临床优势。
2007年6月至2011年6月期间，174名女性入住韩美大学医学中心（HUMC），并接受了阴道穹窿和子宫脱垂的盆腔重建手术。经回顾病历，选取174例有盆腔器官脱垂症状且巴登-沃克脱垂分级≥2级的患者，分为以下两组：阴道手术组（n = 120）和腹腔镜手术组（n = 54）。我们通过分析学生t检验和χ²检验或适当的费舍尔精确检验来比较临床结果。
无再次手术复发的成功率存在显著差异，分别为91.7%（阴道手术组，n = 110）和100%（腹腔镜手术组，n = 54），p = 0.032。阴道手术组的平均随访时间为31.3±7.6个月，腹腔镜手术组为29.7±9.7个月。阴道手术组的导尿管留置时间（4.7±1.9天对3.4±2.1天，p<0.001）和术后住院时间（6.4±2.1天对5.0±1.9天，p<0.001）明显更长，而腹腔镜手术组的手术时间明显更长（108.2±38.6分钟对168.3±69.7分钟，p<0.001）。
我们的结果表明，腹腔镜骶骨阴道固定术的再次手术复发率显著降低，导尿时间缩短，但手术时间增加。
