Zhao Ying, Xia Zhi-Jun, Hu Qing, Qin Mei-Ying
Department of Obstetrics and Gynaecology, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China.
Ther Clin Risk Manag. 2020 Sep 14;16:861-870. doi: 10.2147/TCRM.S267832. eCollection 2020.
To investigate the effect of total pelvic floor reconstruction with a six-arm mesh in the treatment of pelvic organ prolapse.
This is a retrospective observational cohort study. A total of 368 patients with pelvic organ prolapse underwent pelvic floor reconstruction surgery. Patients were categorized by the type of surgical mesh: 176 patients received a six-arm mesh and 192 patients received an anteroposterior approach mesh. The 1-year effect of the two groups was compared. The Pelvic Floor Distress Inventory Questionnaire (PFDI-20), Colorectal-Anal Distress Inventory (CRADI-8) and the Pelvic Organ Prolapse Quantitation (POP-Q) staging were used for evaluation. The incidence of complications was recorded. A cure standard was registered by a POP-Q score of grade I or below. A P value <0.05 indicates the difference is statistically significant.
There was no recurrence documented in the patients; the cure rate was 100% in both groups. After surgery, the length of the vagina in the six-arm mesh group was longer than that of the control group at 6 months and 12 months, respectively ( < 0.05). The six-arm mesh group had lower PFDI-20 and CRADI-8 scores after surgery than those of the control group at 6 and 12 months, respectively ( < 0.05). Pelvic floor and rectal dysfunction symptom improvement were superior in the six-arm mesh group compared with the control group. After surgery, the Female Sexual Function Inventory (FSFI) score of the six-arm mesh group was superior to that of the control group at 6 and 12 months, respectively ( < 0.05). The incidence of complications in the six-arm mesh group was lower than that of the control group ( < 0.05).
The total pelvic floor reconstruction using six-arm mesh has the same healing rate as anteroposterior approach mesh surgery, and it is better than traditional surgery in improving subjective symptoms and reducing postoperative complications.
探讨采用六臂网片进行全盆底重建术治疗盆腔器官脱垂的效果。
这是一项回顾性观察队列研究。共有368例盆腔器官脱垂患者接受了盆底重建手术。患者按手术网片类型分类：176例患者接受六臂网片，192例患者接受前后入路网片。比较两组的1年疗效。采用盆底功能障碍性问卷（PFDI-20）、结直肠肛门功能障碍性问卷（CRADI-8）和盆腔器官脱垂定量分期（POP-Q）进行评估。记录并发症发生率。治愈标准为POP-Q评分I级及以下。P值<0.05表示差异具有统计学意义。
患者均无复发记录；两组治愈率均为100%。术后，六臂网片组阴道长度在6个月和12个月时分别长于对照组（<0.05）。六臂网片组术后PFDI-20和CRADI-8评分在6个月和12个月时分别低于对照组（<0.05）。与对照组相比，六臂网片组盆底和直肠功能障碍症状改善更优。术后，六臂网片组女性性功能指数（FSFI）评分在6个月和12个月时分别优于对照组（<0.05）。六臂网片组并发症发生率低于对照组（<0.05）。
采用六臂网片进行全盆底重建术与前后入路网片手术的治愈率相同，在改善主观症状和减少术后并发症方面优于传统手术。
