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腹腔镜骶骨阴道固定术与开放性腹部骶骨阴道固定术治疗盆腔器官脱垂的比较:一项回顾性队列研究。

Laparoscopic sacrocolpopexy versus open abdominal sacrocolpopexy for pelvic organ prolapse repair: A retrospective cohort study.

作者信息

Cho Eun Hye, Shin Eun Seo, Kim Sung Yob

机构信息

Department of Obstetrics and Gynecology, School of Medicine, Ewha Womans University Seoul Hospital, Seoul, South Korea.

Department of Obstetrics and Gynecology, School of Medicine, Jeju National University Hospital, Jeju Self-Governing Province, South Korea.

出版信息

Ann Med Surg (Lond). 2022 May 24;78:103852. doi: 10.1016/j.amsu.2022.103852. eCollection 2022 Jun.

Abstract

INTRODUCTION

Pelvic organ prolapse (POP) is a progressive herniation of the pelvic organs through the urogenital diaphragm and commonly leads to vaginal bulge. Sacrocolpopexy is a procedure that surgically corrects POP and can be performed as open abdominal surgery or laparoscopic surgery. This study was performed to compare the therapeutic efficacies of laparoscopic and abdominal sacrocolpopexy with hysterectomy.

METHODS

The medical records of 105 patients who had undergone laparoscopic or open abdominal sacrocolpopexy with hysterectomy at Jeju National University Hospital were retrospectively reviewed. We compared the basic characteristics and clinical outcomes of these two groups of patients.

RESULTS

No significant difference was observed between the characteristics of the patients in the abdominal-approach group and the laparoscopic-approach group. The laparoscopic-approach group had a lower intraoperative estimated blood loss (177.8 vs. 89.3 mL, 0.001) and a shorter operative time (132.0 vs. 112.3 min, 0.001) than the abdominal-approach group. The complication rates of the two groups were not significantly different.

CONCLUSION

The results of our study favor the use of a laparoscopic approach for sacrocolpopexy with hysterectomy. The less invasive method leads to less blood loss and a shorter operative time than an open approach, while maintaining a comparable rate of complications.

摘要

引言

盆腔器官脱垂(POP)是盆腔器官通过泌尿生殖膈的进行性疝出,通常导致阴道膨出。骶骨阴道固定术是一种通过手术矫正POP的方法,可作为开放性腹部手术或腹腔镜手术进行。本研究旨在比较腹腔镜和腹部骶骨阴道固定术联合子宫切除术的治疗效果。

方法

回顾性分析济州国立大学医院105例行腹腔镜或开放性腹部骶骨阴道固定术联合子宫切除术患者的病历。我们比较了这两组患者的基本特征和临床结局。

结果

腹部入路组和腹腔镜入路组患者的特征之间未观察到显著差异。腹腔镜入路组术中估计失血量低于腹部入路组(177.8 vs. 89.3 mL,P = 0.001),手术时间也更短(132.0 vs. 112.3分钟,P = 0.001)。两组的并发症发生率无显著差异。

结论

我们的研究结果支持在骶骨阴道固定术联合子宫切除术中使用腹腔镜入路。与开放手术相比,这种侵入性较小的方法导致失血量更少、手术时间更短,同时保持了相当的并发症发生率。

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