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经阴道前壁和前顶脱垂手术治疗中采用 Uphold LITE 网片的临床评估:一项前瞻性、多中心试验。

Clinical evaluation of the Uphold LITE mesh for the surgical treatment of anterior and apical prolapse: A prospective, multicentre trial.

机构信息

Department of Obstetrics and Gynaecology, Nîmes University Hospital, Nîmes, France.

Department of Obstetrics and Gynaecology, Dunkerque Hospital, Dunkerque, France.

出版信息

Neurourol Urodyn. 2019 Nov;38(8):2242-2249. doi: 10.1002/nau.24125. Epub 2019 Jul 29.

Abstract

AIMS

To evaluate the safety and efficacy of the Uphold LITE mesh in the treatment of pelvic organ prolapse at 12-month follow-up.

METHODS

Women undergoing a mesh surgery due to an anterior prolapse plus a symptomatic anterior prolapse (classed as pelvic organ prolapse quantification stage ≥2) were included in this prospective, multicentre, observational study. The primary endpoint was a composite outcome including a good anatomical correction, no prolapse symptoms, and no reintervention for an anterior or apical recurrent prolapse within 12 months of surgery. Secondary outcomes included safety, improvements in quality of life (QoL), and risk factor for recurrence. This study was registered with ClinicalTrials.gov, number NCT01559168.

RESULTS

A total of 121 patients were included. Symptomatic and anatomic cure rates were 94% (95 of 101) and 76.8% (76 of 99), respectively. The composite success rate was 72.4% (71 of 98). The rate of reoperation for apical or anterior recurrent prolapse was 3.9% (4 of 103). Anatomical anterior or apical recurrence occurred in 18.2% (18 of 97) and 7.2% (7 of 97) of patients, respectively. The composite success rate was significantly higher in centres where more than 30 patients had been treated (80% vs 50%; P = .045). The rate of serious complication was 5.4% (6 of 111). Improvements were recorded in QoL including sexual function.

CONCLUSIONS

The Uphold LITE mesh procedure provides satisfactory outcomes in the treatment of anterior and apical prolapse, particularly in high-volume centres. The rates of adverse effects and reintervention for recurrent prolapse were acceptable.

摘要

目的

评估 Uphold LITE 网片在治疗盆腔器官脱垂中的安全性和疗效,随访时间为 12 个月。

方法

本前瞻性、多中心、观察性研究纳入了因前盆腔器官脱垂伴症状性前盆腔器官脱垂(根据盆腔器官脱垂量化分期≥2 级)而行网片手术的女性。主要终点为 12 个月内手术的综合结果,包括解剖学矫正良好、无脱垂症状、无前或顶复发脱垂再次干预。次要结局包括安全性、生活质量(QoL)改善和复发的危险因素。本研究在 ClinicalTrials.gov 上注册,编号为 NCT01559168。

结果

共纳入 121 例患者。症状和解剖学治愈率分别为 94%(101 例中的 95 例)和 76.8%(99 例中的 76 例)。综合成功率为 72.4%(98 例中的 71 例)。顶或前复发脱垂的再手术率为 3.9%(103 例中的 4 例)。解剖学上的前或顶复发分别发生在 18.2%(97 例中的 18 例)和 7.2%(97 例中的 7 例)的患者中。在治疗超过 30 例患者的中心,综合成功率显著更高(80%比 50%;P=0.045)。严重并发症发生率为 5.4%(111 例中的 6 例)。生活质量(包括性功能)得到改善。

结论

Uphold LITE 网片在治疗前盆腔器官脱垂和顶盆腔器官脱垂中提供了满意的结果,特别是在高容量中心。不良事件和复发脱垂的再干预率是可以接受的。

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