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盆腔重建与妇科肿瘤相关手术联合应用的可行性

Feasibility of combining pelvic reconstruction with gynecologic oncology-related surgery.

作者信息

Kohut Adrian, Whitaker Taylor, Walter Logan, Li Susan Y, Han Elinor, Lee Stephen, Wakabayashi Mark T, Dellinger Thanh H, Han Ernest S, Rodriguez-Rodriguez Lorna, Chung Christopher

机构信息

Department of Surgery, Division of Gynecologic Oncology, City of Hope Comprehensive Cancer Center, 1500 E. Duarte Road, Duarte, CA, 91010, USA.

出版信息

Int Urogynecol J. 2023 Jan;34(1):177-183. doi: 10.1007/s00192-022-05212-7. Epub 2022 May 2.

Abstract

INTRODUCTION AND HYPOTHESIS

At our institution, every patient seen by the gynecologic oncology service is screened for pelvic floor dysfunction. This study was aimed at determining if a combined surgical approach by gynecologic oncology and urogynecology services at our institution was feasible and safe for this patient population.

METHODS

We performed a retrospective review of patients undergoing combined surgery by gynecologic oncology and urogynecology services at our institution from 2013 to 2021. Perioperative variables, postoperative adverse events, and long-term outcomes were assessed, and descriptive statistics were performed.

RESULTS

From 20 December 2013 to 29 January 2021, a total of 102 patients underwent concurrent surgical repair of pelvic organ prolapse and/or stress urinary incontinence. Seventy-three patients (71.6%) had normal/benign pathologic conditions, and 29 (28.4%) had premalignant/malignant pathologic conditions. Ten patients (9.8%) had a postoperative complication, including reoperation for exposed midurethral sling (4.9%), urinary retention requiring midurethral sling release (2.9%), reoperation for hemoperitoneum (1.0%), and anemia requiring blood transfusion (1.0%). Nine complications occurred in patients with benign/normal pathologic conditions (12.3%), and one complication occurred in patients with pre-malignant/malignant pathologic conditions (3.4%).

CONCLUSIONS

In our single-institution experience, concurrent gynecologic oncology and pelvic floor reconstructive surgery were safe and feasible in combination with no reported major morbidity events.

摘要

引言与假设

在我们机构,妇科肿瘤服务所接诊的每位患者都要接受盆底功能障碍筛查。本研究旨在确定我们机构的妇科肿瘤与女性盆底重建外科联合手术方法对这类患者群体是否可行且安全。

方法

我们对2013年至2021年期间在我们机构接受妇科肿瘤与女性盆底重建外科联合手术的患者进行了回顾性研究。评估围手术期变量、术后不良事件和长期结局,并进行描述性统计。

结果

从2013年12月20日至2021年1月29日,共有102例患者同时接受了盆腔器官脱垂和/或压力性尿失禁的手术修复。73例患者(71.6%)病理状况正常/为良性,29例(28.4%)为癌前/恶性病理状况。10例患者(9.8%)出现术后并发症,包括因中段尿道吊带外露而再次手术(4.9%)、因尿潴留需要松解中段尿道吊带(2.9%)、因腹腔积血再次手术(1.0%)以及因贫血需要输血(1.0%)。9例并发症发生在病理状况为良性/正常的患者中(12.3%),1例并发症发生在癌前/恶性病理状况的患者中(3.4%)。

结论

根据我们单机构的经验,妇科肿瘤手术与盆底重建手术联合进行是安全可行的,且未报告重大发病事件。

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