Park Jung Yeon, Han Soo Jin, Kim Jun Hwan, Chun Kyoung Chul, Lee Taek Sang
Department of Obstetrics and Gynecology, HerYooJae women's Hospital, Gyeonggi, South Korea.
Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, South Korea.
Taiwan J Obstet Gynecol. 2019 Mar;58(2):206-211. doi: 10.1016/j.tjog.2019.01.007.
The aim of this study was to evaluate the outcomes of women with advanced apical prolapse who were treated with the obliterative LeFort partial colpocleisis (LFC) procedure.
We reviewed the medical records of patients who underwent LFC for advanced apical prolapse. We collected data for baseline patient characteristics, co-morbidities, severity of prolapse, operating time, intraoperative injuries, and postoperative complications. Subjective postoperative outcomes and patient satisfaction levels were also assessed.
Ninety-five patients underwent LFC during the study period. Median age of patients at operation was 76.0years. Mean operation time was 121.5 ± 31.9 min. Mean postoperative hospital stay was 3.5 ± 1.6 days. Postoperative complications, which were virtually all urinary symptoms, were present in 29.8% of patients, and 89.3% of patients have been in spontaneous remission. There was one case with perineal wound infection, one case of prolapse recurrence, and one case of de novo rectal prolapse after LFC. The objective success rate of the LFC procedure for all patients was 98.9% (94/95). Most (96%) patients were satisfied with the LFC results and pleased with the improvement in body image.
The obliterative LFC procedure had a high success rate and was associated with minimal adverse events for the elderly patients with advanced apical prolapse. This procedure should be considered as a treatment option for the advanced apical prolapse in selected elderly women who do not want to conserve vaginal intercourse, as it offers improvement in quality of life and is associated with a low regret rate.
本研究旨在评估接受闭塞性LeFort部分阴道封闭术（LFC）治疗的晚期顶端脱垂女性的治疗效果。
我们回顾了接受LFC治疗晚期顶端脱垂患者的病历。我们收集了患者的基线特征、合并症、脱垂严重程度、手术时间、术中损伤及术后并发症等数据。还评估了术后主观结果和患者满意度。
在研究期间，95例患者接受了LFC手术。患者手术时的中位年龄为76.0岁。平均手术时间为121.5±31.9分钟。术后平均住院时间为3.5±1.6天。术后并发症几乎均为泌尿系统症状，29.8%的患者出现并发症，89.3%的患者已自然缓解。LFC术后有1例会阴伤口感染、1例脱垂复发和1例新发直肠脱垂。所有患者LFC手术的客观成功率为98.9%（94/95）。大多数（96%）患者对LFC结果满意，并对身体形象的改善感到满意。
闭塞性LFC手术成功率高，对于晚期顶端脱垂的老年患者，不良事件最少。对于不想保留阴道性交的特定老年女性晚期顶端脱垂患者，该手术应被视为一种治疗选择，因为它能改善生活质量且后悔率低。
