经阴道自然腔道内镜手术与传统阴道手术治疗阴道顶端膨出的骶棘韧带固定术：回顾性分析。

Transvaginal natural orifice transluminal endoscopic surgery versus conventional vaginal surgery for sacrospinous ligament fixation of apical compartment prolapse: a retrospective analysis.

机构信息

Department of Gynecology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, People's Republic of China.

出版信息

BMC Surg. 2023 Jan 28;23(1):24. doi: 10.1186/s12893-023-01921-y.

DOI:10.1186/s12893-023-01921-y

PMID:36707831

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9883968/

Abstract

BACKGROUND

To objectively assess the safety, feasibility, advantages, and disadvantages of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) versus conventional vaginal (CV) surgery for sacrospinous ligament fixation (SSLF).

METHODS

We retrospectively analyzed the data of patients who underwent hysterectomy for SSLF via vNOTES or CV surgery due to apical compartment prolapse between April 2019 and April 2020 at our hospital. The patients were classified into the vNOTES group (n = 31) and CV surgery group (n = 51) based on surgical approach and their general characteristics and perioperative outcomes compared.

RESULTS

The two groups had similar general characteristics. The anatomical success and bilateral salpingo-oophorectomy rates were higher in the vNOTES than CV surgery group, while the postoperative stay was shorter in the vNOTES than CV surgery group. All differences were statistically significant. However, there were no statistically significant intergroup differences in operation time, bilateral salpingectomy rate, colporrhaphy rate, postoperative visual analog scale score, estimated blood loss, hemoglobin decrease at 72 h postoperative, maximum body temperature at 72 h postoperative, complication rate, buttock pain, or Pelvic Floor Impact Questionnaire-7 and Pelvic Floor Distress Inventory Questionnaire-20 scores at 1 year postoperative.

CONCLUSIONS

VNOTES for SSLF was safe and feasible and resulted in superior objective and subjective outcomes versus CV surgery for SSLF. These findings suggest that vNOTES could be an alternative to CV surgery for SSLF.

摘要

背景

客观评估经阴道自然腔道内镜手术（vNOTES）与传统阴道手术（CV）治疗骶骨固定术（SSLF）的安全性、可行性、优缺点。

方法

我们回顾性分析了 2019 年 4 月至 2020 年 4 月我院因 apical compartment prolapse 行 SSLF 经 vNOTES 或 CV 手术的患者数据。根据手术方法将患者分为 vNOTES 组（n=31）和 CV 手术组（n=51），比较两组的一般特征和围手术期结果。

结果

两组一般特征相似。vNOTES 组解剖成功率和双侧输卵管卵巢切除术率高于 CV 手术组，而 vNOTES 组术后住院时间短于 CV 手术组。所有差异均有统计学意义。然而，两组在手术时间、双侧输卵管切除术率、阴道修补术率、术后视觉模拟评分、估计失血量、术后 72 小时血红蛋白下降、术后 72 小时最高体温、并发症发生率、臀部疼痛、1 年后 Pelvic Floor Impact Questionnaire-7 和 Pelvic Floor Distress Inventory Questionnaire-20 评分方面无统计学差异。