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改良骶棘韧带固定术经阴道前壁路径治疗盆腔器官脱垂的临床疗效评估:基于50例患者的可行性报告

Evaluation of the clinical effectiveness of modified sacrospinous ligament fixation the anterior vaginal wall path for pelvic organ prolapse: A feasibility report based on 50 patients.

作者信息

Lyu Yuanyuan, Ding Huafeng, Zhang Ying, Shi Suhua, Ding Jin, Zhu Chengcheng, Guan Xiaoming, Ni Guantai, Luo Yonghong

机构信息

Department of Obstetrics and Gynecology, The First Affiliated Hospital of Wannan Medical College, Wuhu, China.

Department of Obstetrics and Gynecology, Baylor College of Medicine Minimally Invasive Gynecology Surgery, Houston, TX, United States.

出版信息

Front Surg. 2022 Nov 2;9:1010027. doi: 10.3389/fsurg.2022.1010027. eCollection 2022.

Abstract

OBJECTIVE

To describe the surgical techniques and short-term outcomes for 50 cases of modified sacrospinous ligament fixation the anterior vaginal wall path for pelvic organ prolapse.

METHODS

100 patients with pelvic organ prolapse (stage III or stage IV based on POP-Q staging) from January 2018 to January 2020 were retrospectively analyzed. Among them, 50 patients received modified sacrospinous ligament fixation the anterior vaginal wall path for pelvic organ prolapse (mSSLF group), while the other 50 patients received pelvic reconstruction using T4 mesh (T4 group). Operative time, blood loss, postoperative POP-Q score, length of the hospital stay, complications, and postoperative pain were compared between the two groups.

RESULTS

The duration of the operation in mSSLF group was (50 ± 15.2 min), which was shorter than that of the T4 group (60 ± 14.8 min) (= 0.02). No intraoperative complications were reported from the mSSLF group, whereas one vascular injury occurred in the T4 group. In both groups, postoperative pain and painful intercourse was significantly lower in the mSSLF group than in the SSLF group ( < 0.001). The exposed mesh rate was lower than T4 group.

CONCLUSIONS

The rates of intraoperative complications, postoperative pain and mesh erosion were significantly lower than those of the T4 group, but there was no significant difference in the efficacy and safety of the treatment of pelvic organ prolapse. So mSSLF may be a feasible technique to manage severe prolapse, with promising short-term efficacy and safety.

摘要

目的

描述50例经阴道前壁路径改良骶棘韧带固定术治疗盆腔器官脱垂的手术技术及短期疗效。

方法

回顾性分析2018年1月至2020年1月收治的100例盆腔器官脱垂患者(根据POP-Q分期为Ⅲ期或Ⅳ期)。其中,50例患者采用经阴道前壁路径改良骶棘韧带固定术(mSSLF组),另外50例患者采用T4补片进行盆底重建(T4组)。比较两组患者的手术时间、出血量、术后POP-Q评分、住院时间、并发症及术后疼痛情况。

结果

mSSLF组手术时间为(50±15.2)分钟,短于T4组(60±14.8)分钟(P=0.02)。mSSLF组未报告术中并发症,而T4组发生1例血管损伤。两组患者术后疼痛及性交痛方面,mSSLF组均显著低于T4组(P<0.001)。mSSLF组补片外露率低于T4组。

结论

mSSLF组术中并发症、术后疼痛及补片侵蚀发生率均显著低于T4组,但在盆腔器官脱垂治疗的疗效和安全性方面差异无统计学意义。因此,mSSLF可能是治疗重度脱垂的一种可行技术,具有良好的短期疗效和安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bdb1/9666683/c092d4912cf2/fsurg-09-1010027-g001.jpg

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