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机器人网片骶骨阴道固定术的长期疗效

Long-term outcomes of robotic mesh sacrocolpopexy.

作者信息

Jong Karen, Klein Ted, Zimmern Philippe E

机构信息

UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9110, USA.

出版信息

J Robot Surg. 2018 Sep;12(3):455-460. doi: 10.1007/s11701-017-0757-2. Epub 2017 Oct 4.

Abstract

The aim of the study is to evaluate anatomic and functional late-term outcomes of robotic mesh sacrocolpopexy (RMS) at a single tertiary-care institution. Following IRB approval, a retrospective chart review of a prospectively collected database on consecutive patients who underwent RMS for symptomatic pelvic organ prolapse and had 3 year minimum follow-up was performed. Data collected included physical examination, validated questionnaires including Urogenital Distress Inventory, Incontinence Impact Questionnaire, and global Quality of Life (QOL). The primary outcome was failure defined as the need for re-operation and/or prolapse recurrence by examination. Those with office follow-up < 36 months underwent structured phone interviews. Between 12/2007 and 2/2012, 56 women underwent RMS. Thirty women had follow-up ≥ 3 years (median 64 (IQR 48-85) months). Mean C-point went from - 2.33 (range 0 to - 5) to - 9.00 (0 to - 12) (p < 0.01), and mean QOL score from 3.93 (0-10) to 1.93 (0-8) (p < 0.01). Two developed recurrent vault prolapse later on at 26 and 34 months, respectively. Four women (13%) required surgery for secondary prolapses, with three for anterior compartment and one for posterior compartment. Sixteen of twenty six were contacted via structured phone interviews, with 14 doing well, one deceased, and one who underwent a secondary posterior compartment prolapse 6 years later at an outside facility. This long-term study indicates durability for RMS in the management of symptomatic pelvic organ prolapse.

摘要

本研究的目的是在一家三级医疗机构评估机器人网状骶骨阴道固定术(RMS)的解剖学和功能远期疗效。经机构审查委员会(IRB)批准,对一个前瞻性收集的数据库进行回顾性图表审查,该数据库收录了因症状性盆腔器官脱垂接受RMS且至少随访3年的连续患者。收集的数据包括体格检查、经过验证的问卷,如泌尿生殖系统困扰量表、尿失禁影响问卷和总体生活质量(QOL)。主要结局为失败,定义为需要再次手术和/或经检查发现脱垂复发。门诊随访时间不足36个月的患者接受了结构化电话访谈。2007年12月至2012年2月期间,56名女性接受了RMS。30名女性随访时间≥3年(中位时间64(四分位间距48 - 85)个月)。平均C点从 - 2.33(范围0至 - 5)变为 - 9.00(0至 - 12)(p < 0.01),平均生活质量评分从3.93(0 - 10)变为1.93(0 - 8)(p < 0.01)。两名患者分别在术后26个月和34个月出现了复发性穹窿脱垂。四名女性(13%)因继发性脱垂需要手术,其中三名是前盆腔手术,一名是后盆腔手术。26名患者中有16名接受了结构化电话访谈,其中14名情况良好,一名死亡,一名在6年后于外部机构出现继发性后盆腔脱垂。这项长期研究表明RMS在治疗症状性盆腔器官脱垂方面具有持久性。

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