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腹腔镜下单网片骶骨子宫固定术后患者报告的中长期结果令人满意。

Satisfactory medium-long term patient reported outcomes after laparoscopic single-mesh sacrohysteropexy.

作者信息

Dökmeci F, Şükür Y E, Çetinkaya Ş E, Seval M M, Varlı B

出版信息

Facts Views Vis Obgyn. 2022 Jun;14(2):139-145. doi: 10.52054/FVVO.14.2.017.

Abstract

BACKGROUND

There is scarce information on the effectiveness of the laparoscopic single mesh sacrohysteropexy (smSHP). Attachment of a single sheet of flat mesh posteriorly to the cervix provides less mesh use and a less invasive distal mesh fixation.

OBJECTIVES

To assess medium to long-term follow-up results of patients who underwent laparoscopic smSHP utilising a less invasive technique with single sheet flat mesh.

MATERIALS AND METHODS

In the present retrospective cohort study, the data of 71 women who underwent laparoscopic smSHP for apical uterine prolapse with or without colporrhaphy (anterior and/or posterior) at the urogynaecology unit of a university hospital between January 2008 and January 2020 was reviewed. Data was collected on demographics, presenting symptoms, preoperative findings, surgery, and postoperative outcomes.

MAIN OUTCOME MEASURES

Medium to long-term patient-reported outcomes.

RESULTS

The median age of the study population was 44 years. Median follow-up duration was 5 years (1-12). Symptomatic recurrence over time and repeat surgery rates were 13.1% and 3.1% respectively. Comparison of the pre-operative and medium to long-term evaluation scores of the pelvic floor distress inventory-20 (PFDI-20) and assessment of the patient global impression of improvement (PGI-I) revealed long-standing improvement in pelvic floor dysfunction.

CONCLUSIONS

Laparoscopic smSHP appears to be successful and safe with low recurrence and complication rates and provides satisfactory patient reported outcomes.

WHAT'S NEW?: Medium to long-term patient-reported outcomes based on PFDI-20 and PGI-I surveys are satisfactory following smSHP.

摘要

背景

关于腹腔镜单网片骶骨子宫固定术(smSHP)有效性的信息稀缺。将单层扁平网片附着于宫颈后方可减少网片使用量,并降低远端网片固定的侵入性。

目的

评估采用单层扁平网片的微创技术进行腹腔镜smSHP患者的中长期随访结果。

材料与方法

在本回顾性队列研究中,回顾了2008年1月至2020年1月期间在一所大学医院的泌尿妇科接受腹腔镜smSHP治疗子宫顶端脱垂伴或不伴阴道修补术(前壁和/或后壁)的71名女性的数据。收集了人口统计学、呈现症状、术前检查结果、手术及术后结果等数据。

主要观察指标

患者报告的中长期结果。

结果

研究人群的中位年龄为44岁。中位随访时间为5年(1 - 12年)。随时间推移的症状复发率和再次手术率分别为13.1%和3.1%。盆底功能障碍指数-20(PFDI-20)术前与中长期评估得分的比较以及患者整体改善印象(PGI-I)评估显示盆底功能障碍有长期改善。

结论

腹腔镜smSHP似乎成功且安全,复发率和并发症率低,并能提供患者报告的满意结果。

新发现

基于PFDI-20和PGI-I调查的患者报告的中长期结果在smSHP后令人满意。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75e5/10191707/b37938050bfd/FVVinObGyn-14-139-g001.jpg

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