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腹腔镜高位子宫骶韧带悬吊术后生活质量的恢复:一项单中心观察性研究

Quality of life recovery after laparoscopic high uterosacral ligament suspension: a single centre observational study.

作者信息

Panico Giovanni, Vacca Lorenzo, Campagna Giuseppe, Lombisani Andrea, Caramazza Daniela, Caporale Nicola, Scambia Giovanni, Ercoli Alfredo

机构信息

Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Uroginecologia e Chirurgia Ricostruttiva del Pavimento Pelvico, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy.

Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Uroginecologia e Chirurgia Ricostruttiva del Pavimento Pelvico, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2021 May;260:212-217. doi: 10.1016/j.ejogrb.2021.03.035. Epub 2021 Apr 1.

Abstract

OBJECTIVE

Laparoscopic high uterosacral ligament suspension (l-HUSLS) is a laparoscopic-transposed vaginal technique for the treatment of pelvic organ prolapse. Nowadays data regarding quality of life and sexual functions in patients who underwent l-HUSLS for pelvic organ prolapse are few and generic with most of the study investigating the anatomical outcome. For these reasons, the aim of our study is to evaluate these subjective outcomes in women undergoing this surgical procedure with the support of validated questionnaires.

STUDY DESIGN

This is a retrospective study with the primary aim of analysing the quality of life, sexual function, patient satisfaction rates and anatomical outcome among patients who underwent l-HUSLS in our institution. The SPSS Version 26.0 for Windows (Statistical package for the social studies, Chicago, IL, USA) was used for the statistical analysis.

RESULTS

A total of 60 patients underwent l-HUSLS between 2016 and 2018. All patients had a high grade of apical prolapse. No intraoperative and major postoperative complications were registered. The median follow-up was 24 months (24-48). PGI-I score was 1-2 in 55 (91.6 %) women. We observed a significant improvement of EQ-5D index and VAS scores from the baseline to the 2 years follow-up: from 0.72 (0.67-1) to 0.91 (0.79-1) and from 50 (30-90) to 70 (50-100) respectively (p = 0.000). All women showed a statistically significant amelioration of FSDS and ICIQ-SF scores. Anatomical success rate after 24 months was 83.7 %.

CONCLUSIONS

l-HUSLS appears to be a safe, feasible and effective treatment for advanced pelvic organ prolapse with high rates of patient self-reported cure.

摘要

目的

腹腔镜高位子宫骶韧带悬吊术(l-HUSLS)是一种用于治疗盆腔器官脱垂的腹腔镜下经阴道技术。目前,关于接受l-HUSLS治疗盆腔器官脱垂患者的生活质量和性功能的数据较少且缺乏针对性,大多数研究都在调查解剖学结果。基于这些原因,我们研究的目的是在经过验证的问卷支持下,评估接受该手术的女性的这些主观结果。

研究设计

这是一项回顾性研究,主要目的是分析在我们机构接受l-HUSLS治疗的患者的生活质量、性功能、患者满意度和解剖学结果。使用Windows版SPSS 26.0(社会科学统计软件包,美国伊利诺伊州芝加哥)进行统计分析。

结果

2016年至2018年期间,共有60例患者接受了l-HUSLS治疗。所有患者均有高度的顶端脱垂。未记录到术中及术后严重并发症。中位随访时间为24个月(24 - 48个月)。55名(91.6%)女性的PGI-I评分为1 - 2分。我们观察到EQ-5D指数和VAS评分从基线到2年随访有显著改善:分别从0.72(0.67 - 1)提高到0.91(0.79 - 1),从50(30 - 90)提高到70(50 - 100)(p = 0.000)。所有女性的FSDS和ICIQ-SF评分均有统计学意义的改善。24个月后的解剖学成功率为83.7%。

结论

l-HUSLS似乎是一种安全、可行且有效的治疗晚期盆腔器官脱垂的方法,患者自我报告的治愈率较高。

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