Kong Wei, Cheng Xinghan, Xiong Guangwu
Women's and Children's Health Centre, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China.
JSLS. 2018 Apr-Jun;22(2). doi: 10.4293/JSLS.2017.00105.
Laparoscopic sacrospinous ligament suspension, as commonly performed, is associated with extensive stripping, high risk of intraoperative bleeding, and prolonged operative time. We explore the safety and feasibility of posterior laparoscopic approach sacrospinous ligament suspension (LPASLS) in the treatment of pelvic organ prolapse (POP).
We retrospectively analyzed the clinical data of 9 patients with symptomatic POP treated intraoperatively with LPASLS at the Women's and Children's Health Centre, The Third Affiliated Hospital of Chongqing Medical University, between November 2016 and July 2017. Regular follow-up was performed at 1, 3, and 6 months after the operation. Subjective cure was considered as the absence of any postoperative subjective symptoms, and objective cure was considered as a postoperative POP-Q grade of 0.
All operations were completed successfully. The operative time ranged from 90 to 140 (mean, 117.78 ± 20.01) minutes, and the mean suspension time was about 30 minutes. The intraoperative estimated blood loss ranged from 30 to 100 (range, 54.9 ± 24.2) mL, and pelvic vascular injury occurred in 1 patient. Postoperative sacrococcygeal pain occurred in 5 patients, and Visual Analog Scale scores ranged from 3 to 4 (mean, 3.4 ± 0.5). The symptom disappeared without any treatment after 3-4 d. Patients were followed up for 3-10 (mean, 6.3 ± 2.1) months, and the subjective and objective cure rates were both 100%.
LPASLS is safe and feasible and may be considered as an alternative approach to traditional laparoscopic sacrospinous ligament suspension.
常规实施的腹腔镜骶棘韧带悬吊术存在广泛剥离、术中出血风险高及手术时间延长等问题。我们探讨后腹腔镜骶棘韧带悬吊术（LPASLS）治疗盆腔器官脱垂（POP）的安全性和可行性。
回顾性分析2016年11月至2017年7月在重庆医科大学附属第三医院妇女儿童健康中心接受LPASLS手术治疗的9例有症状POP患者的临床资料。术后1、3和6个月进行定期随访。主观治愈定义为术后无任何主观症状，客观治愈定义为术后POP-Q分级为0级。
所有手术均成功完成。手术时间为90至140（平均117.78±20.01）分钟，平均悬吊时间约为30分钟。术中估计失血量为30至100（平均54.9±24.2）毫升，1例患者发生盆腔血管损伤。5例患者术后出现骶尾部疼痛，视觉模拟评分3至4分（平均3.4±0.5）。3至4天后症状未经任何治疗自行消失。患者随访3至10（平均6.3±2.1）个月，主观和客观治愈率均为100%。
LPASLS安全可行，可作为传统腹腔镜骶棘韧带悬吊术的替代方法。
