Kapoor Shveta, Sivanesan Kanapathippillai, Robertson Jessica Amy, Veerasingham Mayooran, Kapoor Vishal
Ipswich Hospital, QLD Health, University of Queensland, Chelmsford Avenue, Ipswich, QLD, 4305, Australia.
Lady Cilento Children's Hospital, QLD Health, University of Queensland, South Brisbane, QLD, Australia.
Int Urogynecol J. 2017 Sep;28(9):1285-1294. doi: 10.1007/s00192-017-3291-x. Epub 2017 Mar 3.
Sacrospinous hysteropexy is a uterine-preserving procedure for treatment of apical prolapse. We present a literature review evaluating the sacrospinous hysteropexy procedure and its current place in the surgical management of pelvic organ prolapse. Additionally, to assess the efficacy of the procedure, we performed a meta-analysis of studies comparing sacrospinous hysteropexy to vaginal hysterectomy and repair in terms of anatomical outcomes, complications, and repeat surgery.
Major literature databases including MEDLINE (1946 to 2 April 2016), Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 3), and Embase (1947 to 2 April 2016) were searched for relevant studies. We used Cochrane Collaboration's Review Manager software to perform meta-analysis of randomized controlled studies and observational studies.
Vaginal sacrospinous hysteropexy was first performed in 1989 and is similar in technique to sacrospinous colpopexy. Two randomized controlled trials and four cohort studies (n = 651) were included in the meta-analysis. Apical failure rates after sacrospinous hysteropexy versus vaginal hysterectomy were not significantly different, although the trend favored vaginal hysterectomy [odds ratio (OR) 2.08; 95% confidence interval (CI) 0.76-5.68]. Rates of repeat surgery for prolapse were not significantly different between the two groups (OR 0.99; 95% CI 0.41-2.37). The most significant disadvantage of uterine-preservation prolapse surgery when compared with hysterectomy is the lack of prevention and diagnosis of uterine malignancy.
Sacrospinous hysteropexy is a safe and effective procedure for pelvic organ prolapse and has comparable outcomes to vaginal hysterectomy with repair.
骶棘韧带子宫固定术是一种保留子宫的治疗子宫顶端脱垂的手术。我们进行了一项文献综述，评估骶棘韧带子宫固定术及其在盆腔器官脱垂手术治疗中的当前地位。此外，为评估该手术的疗效，我们对比较骶棘韧带子宫固定术与阴道子宫切除术及修复术在解剖学结果、并发症和再次手术方面的研究进行了荟萃分析。
检索主要文献数据库，包括MEDLINE（1946年至2016年4月2日）、Cochrane对照试验中心注册库（CENTRAL；2016年第3期）和Embase（1947年至2016年4月2日），以查找相关研究。我们使用Cochrane协作网的Review Manager软件对随机对照研究和观察性研究进行荟萃分析。
阴道骶棘韧带子宫固定术于1989年首次实施，其技术与骶棘韧带阴道固定术相似。荟萃分析纳入了两项随机对照试验和四项队列研究（n = 651）。骶棘韧带子宫固定术后与阴道子宫切除术后的顶端失败率无显著差异，尽管趋势有利于阴道子宫切除术[优势比（OR）2.08；95%置信区间（CI）0.76 - 5.68]。两组脱垂再次手术率无显著差异（OR 0.99；95% CI 0.41 - 2.37）。与子宫切除术相比，保留子宫的脱垂手术最显著的缺点是缺乏子宫恶性肿瘤的预防和诊断。
骶棘韧带子宫固定术是治疗盆腔器官脱垂的一种安全有效的手术，其结果与阴道子宫切除术加修复术相当。
