Department of Obstetrics and Gynecology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
Department of Obstetrics and Gynecology, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu City, Taiwan.
Sci Rep. 2020 Mar 19;10(1):4997. doi: 10.1038/s41598-020-61995-z.
Sacrospinous ligament fixation (SSLF) is one of the most utilized surgeries in the management of pelvic organ prolapse (POP). We conducted a large-series study of SSLF in a tertiary center by an experienced urogynecologic team. The 453 women with POP who underwent SSLF at National Taiwan University Hospital in the period from 2002 to 2015 are reviewed. All patients received unilateral SSLF with Veronikis ligature carrier. Concomitant anterior colporrhaphy was performed in 75.3% of the cases and posterior colporrhaphy in 78.6%. The mean operation time was 92.3 ± 31.5 minutes. The intraoperative blood loss was 92.3 ± 91.4 ml. The objective cure rate was 82.5%, and 79 (17.5%) patients recurred. The Kaplan-Meier recurrence-free analysis showed a steep decline during the first postoperative year, and the yearly number of recurrent patients decreased as the follow-up period proceeded. A comparison of the site of recurrence found that anterior compartment prolapse was the most common with 57 cases (12.6%). Paravaginal repair is frequently implemented in the management of recurrent anterior prolapse. In conclusion, SSLF provides excellent support to the apex compartment, and our long-term results show that the anterior compartment is the most commonly encountered type of POP recurrence.
骶骨固定术（SSLF）是治疗盆腔器官脱垂（POP）最常用的手术之一。我们对一个由经验丰富的妇科泌尿团队在三级中心进行的 SSLF 大型系列研究进行了分析。回顾了 2002 年至 2015 年期间在国立台湾大学医院接受 SSLF 的 453 例 POP 患者。所有患者均接受单侧 SSLF 联合 Veronikis 结扎器。75.3%的病例同时行前阴道修补术，78.6%的病例行后阴道修补术。平均手术时间为 92.3±31.5 分钟。术中出血量为 92.3±91.4ml。客观治愈率为 82.5%，79 例（17.5%）患者复发。Kaplan-Meier 无复发生存分析显示，术后第一年复发率急剧下降，随着随访时间的延长，每年复发患者的数量逐渐减少。对复发部位的比较发现，前盆腔脱垂最常见，有 57 例（12.6%）。复发前盆腔脱垂常采用阴道旁修补术。总之，SSLF 为前盆腔提供了极佳的支撑，我们的长期结果显示，前盆腔是最常见的 POP 复发类型。
