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经阴道自然腔道内镜下骶棘韧带固定术治疗中重度盆腔器官脱垂的初步临床报告

A preliminary clinical report of transvaginal natural orifice transluminal endoscopic Sacrospinous Ligament Fixation in the treatment of moderate and severe pelvic organ prolapse.

作者信息

Qin Zhenyue, Dong Zhiyong, Tang Huimin, Zhang Shoufeng, Wang Huihui, Bao Mingyue, Wei Weiwei, Shi Ruxia, Chen Jiming, Xia Bairong

机构信息

Dalian Medical University, Dalian, China.

Department of Gynecology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China.

出版信息

Front Surg. 2022 Jul 29;9:931691. doi: 10.3389/fsurg.2022.931691. eCollection 2022.

Abstract

OBJECTIVE

To study the efficacy and safety of transvaginal natural orifice transluminal endoscopic Sacrospinous Ligament Fixation in the treatment of moderate and severe pelvic organ prolapse.

DESIGN

Patients were selected into this study on a voluntary basis to evaluate the short-term efficacy of this surgery by comparing the OP-Q scores before the operation, three months after the operation, and six months after the operation.

SETTING AND PATIENTS

Evaluate the clinical efficacy and safety by a retrospective analysis of the clinical data of the 18 patients with POP-Q grade III-IV pelvic organ prolapse treated by the Department of Gynecology of Nanjing Medical University Affiliated Changzhou No.2 People's Hospital from April 2020 to November 2020, and their post-operation follow-ups.

INTERVENTIONS

Patients with postoperative follow-ups found no obvious relapse without intervention measures.

MEASUREMENTS AND MAIN RESULTS

The transvaginal natural orifice transluminal endoscopic Sacrospinous Ligament Fixation was performed successfully, and the anterior and posterior walls of vagina and/or trans-vaginal hysterectomy were repaired as appropriate. Except the total vaginal length (TVL), the values of numerical analysis for all points before, three months after, and six months after the operation were all <0.05, being statistically significant.

CONCLUSION

This method is effective in the treatment of moderate and severe pelvic organ prolapse with few complications, but more cases and longer-term follow-up data are needed to determine the long-term effect of this procedure. For the selection of puncture sites, more anatomical data are needed to get more accurate result.

摘要

目的

探讨经阴道自然腔道内镜下骶棘韧带固定术治疗中重度盆腔器官脱垂的疗效及安全性。

设计

患者自愿入选本研究,通过比较术前、术后3个月及术后6个月的盆腔器官脱垂定量分期(POP-Q)评分来评估该手术的短期疗效。

地点和患者

通过回顾性分析南京医科大学附属常州市第二人民医院妇科2020年4月至2020年11月收治的18例POP-QⅢ-Ⅳ级盆腔器官脱垂患者的临床资料及其术后随访情况,评估临床疗效及安全性。

干预措施

术后随访患者未发现明显复发,未采取干预措施。

测量指标和主要结果

经阴道自然腔道内镜下骶棘韧带固定术成功实施,并酌情修复阴道前后壁和/或经阴道子宫切除术。除阴道总长度(TVL)外,术前、术后3个月及术后6个月所有测量点的数值分析值均<0.05,差异有统计学意义。

结论

该方法治疗中重度盆腔器官脱垂有效,并发症少,但需要更多病例和更长时间的随访数据来确定该手术的长期效果。对于穿刺部位的选择,需要更多的解剖学数据以获得更准确的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd45/9372293/a6304cd07455/fsurg-09-931691-g001.jpg

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