Yu Eun Hee, Jung Ha Eun, Noh Hye Kyung, Joo Jong Kil
Department of Obstetrics and Gynecology, Pusan National University School of Medicine, Pusan National University Hospital Medical Research Institute, Busan, Korea.
J Menopausal Med. 2020 Dec;26(3):165-168. doi: 10.6118/jmm.20029.
Pelvic organ prolapse (POP) is the herniation or bulging of the pelvic organs to or beyond the vaginal introitus. POP is a common condition affecting more than half of parous women. We recently performed POP surgery and repair in 37 patients using laparoscopic pectopexy, a new technique for apical prolapse surgery, in women with advanced POP. The surgery was performed by a single surgeon at a single institute. The methods of operation were divided into total laparoscopic hysterectomy with pectopexy, supracervical hysterectomy with pectopexy or pectopexy alone, with additional anterior or posterior colporrhaphy selectively performed. All patients were analyzed in terms of age, body mass index, parity, estimated blood loss (EBL), operation time, intraoperative complications, and postoperative complications. The patients were followed up for at least 6 months after surgery, and the short-term clinical outcomes were analyzed. All operations were performed successfully and without severe intraoperative or postoperative complications. The mean EBL was 84 mL, and the mean operation time was 121 minutes. The operation satisfaction rates were high in most patients. All patients had no recurrence of apical prolapse, de novo urgency, frequency, incontinence, de novo constipation, or ileus. In our experience, laparoscopic pectopexy is a feasible method for apical prolapse repair as it does not have severe intraoperative or postoperative complications and de novo gastrointestinal complications. Considerable follow-up period for possible postoperative events is warranted.
盆腔器官脱垂（POP）是指盆腔器官向阴道外口或超出阴道外口突出或膨出。POP是一种常见疾病，影响超过半数的经产妇。我们最近对37例患有重度POP的女性患者进行了POP手术及修复，采用腹腔镜耻骨后固定术，这是一种用于顶端脱垂手术的新技术。该手术由一名外科医生在一家机构完成。手术方法分为全腹腔镜子宫切除术加耻骨后固定术、次全子宫切除术加耻骨后固定术或单纯耻骨后固定术，并根据情况选择性地进行额外的前壁或后壁阴道修补术。对所有患者的年龄、体重指数、产次、估计失血量（EBL）、手术时间、术中并发症及术后并发症进行了分析。患者术后至少随访6个月，并对短期临床结局进行了分析。所有手术均成功完成，未出现严重的术中或术后并发症。平均EBL为84 mL，平均手术时间为121分钟。大多数患者的手术满意度较高。所有患者均未出现顶端脱垂复发、新发尿急、尿频、尿失禁、新发便秘或肠梗阻。根据我们的经验，腹腔镜耻骨后固定术是一种可行的顶端脱垂修复方法，因为它不会出现严重的术中或术后并发症以及新发胃肠道并发症。对于可能的术后事件，有必要进行相当长时间的随访。
