Institute of Obstetrics and Gynecology, Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Italy.
Service of Colonic-Proctologic Surgery, Operative Unit of Minimally Invasive and Robotic Surgery, Policlinico of Abano Terme, Italy.
Eur J Obstet Gynecol Reprod Biol. 2019 Sep;240:351-356. doi: 10.1016/j.ejogrb.2019.07.025. Epub 2019 Jul 25.
Illustrating the outcomes of laparoscopic lateral suspension by mesh for pelvic organ prolapse repair.
A retrospective observational study was conducted collecting medical records of 48 patients treated between May 2016 and April 2018 in two different centers in Italy. Pre- and post-operative clinical evaluations as well as patients' satisfaction scores were considered. Patients were followed for two years. Statistical analysis was determined using the chi-square test in intention-to-treat and per-protocol analyses, while Kaplan-Meier curves were built for assessing the prolapse recurrence and the symptoms recurrence. The Steel-Dwass test for pairwise comparisons was used to compare median scores from the King's General Health Perception Questionnaire answers.
Regarding the anatomical result, the outcome was either optimal or satisfactory (PoP-Q ≤1) at 12 months in 92% of patients for anterior compartment, in 100% for apical compartment, and in 75% for posterior compartment (intention-to-treat). Kaplan-Meier curves depicted a repair of prolapse in 70% of cases, with better outcomes for the anterior and the apical compartment. Patient self-perception of health was over 80% at each follow-up evaluation.
Laparoscopic lateral suspension is a reasonable technique for treatment of pelvic organ prolapse. Further studies are needed to prove such a technique versus alternative surgeries.
展示经网片腹腔镜侧方悬吊术治疗盆腔器官脱垂的结果。
本研究为回顾性观察性研究,收集了 2016 年 5 月至 2018 年 4 月在意大利两个不同中心接受治疗的 48 例患者的病历。考虑了术前和术后临床评估以及患者满意度评分。患者随访两年。使用意向治疗和方案分析中的卡方检验进行统计分析,同时构建 Kaplan-Meier 曲线以评估脱垂复发和症状复发。使用 Steel-Dwass 检验进行两两比较,以比较 King's 一般健康感知问卷答案的中位数评分。
在解剖学结果方面,12 个月时,92%的患者前盆腔、100%的患者顶盆腔和 75%的患者后盆腔(意向治疗)的结果为优或满意(PoP-Q≤1)。Kaplan-Meier 曲线显示 70%的病例脱垂得到修复,前盆腔和顶盆腔的结果更好。在每次随访评估中,患者对自身健康的自我感知均超过 80%。
腹腔镜侧方悬吊术是治疗盆腔器官脱垂的合理技术。需要进一步的研究来证明这种技术与替代手术相比的优势。