Lee Sa Ra, Kim Ju Hee, Kim Sung Hoon, Chae Hee Dong
Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea.
J Clin Med. 2021 Apr 22;10(9):1822. doi: 10.3390/jcm10091822.
In this study, we introduce a new wrinkle method for intracorporeal anterior vaginal wall plication during sacrocolpopexy for pelvic organ prolapse (POP) aiming to decrease POP recurrence and postoperative vaginal wall mesh erosion. The wrinkle method was performed using robotic sacrocolpopexy (RSC) on 57 symptomatic POP patients. Sixty-six patients underwent conventional RSC before the development of the wrinkle method. Feasibility and perioperative outcomes were compared. The wrinkle method is not time consuming. The total operative time was shorter in the wrinkle group than in the non-wrinkle group; however, this was attributed to lower adhesiolysis in the wrinkle group. No differences were recorded in the mean estimated blood loss and complication rates between the two groups. In conclusion, although we were unable to confirm that the wrinkle method decreased POP recurrence and vaginal wall mesh erosion after RSC because of the short follow-up period, our preliminary findings are positive in terms of safety. Further long-term well designed randomized controlled trials are required to elucidate the benefits of the wrinkle method.
在本研究中，我们介绍了一种用于盆腔器官脱垂（POP）骶棘韧带固定术中体内阴道前壁折叠的新皱纹法，旨在降低POP复发率和术后阴道壁网片侵蚀的发生率。对57例有症状的POP患者采用机器人骶棘韧带固定术（RSC）实施皱纹法。在皱纹法出现之前，66例患者接受了传统的RSC。比较了可行性和围手术期结果。皱纹法并不耗时。皱纹组的总手术时间比非皱纹组短；然而，这归因于皱纹组较低的粘连松解程度。两组之间的平均估计失血量和并发症发生率没有差异。总之，尽管由于随访期短，我们无法证实皱纹法降低了RSC术后的POP复发率和阴道壁网片侵蚀发生率，但我们的初步研究结果在安全性方面是积极的。需要进一步进行长期精心设计的随机对照试验，以阐明皱纹法的益处。
