Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital, Capital Medical University, 8 Gongtinanlu, Chaoyang District, Beijing, 100020, People's Republic of China.
Arch Gynecol Obstet. 2023 Jun;307(6):1867-1872. doi: 10.1007/s00404-023-06980-3. Epub 2023 Mar 7.
The use of mesh for vaginal repair is currently problematic; consequently, there is increased interest in native tissue repair. Combining native tissue repair with sufficient mesh-applied apical repair might provide effective treatment. We describe the study focusing on the combination of pectopexy and native tissue repair.
Between April 2020 and November 2021, 49 patients with symptomatic stage III or IV were treated with laparoscopic pectopexy combined with native tissue repair. The mesh was solely used for apical repair. All other clinically relevant defects were treated with native tissue repair. The perioperative parameters including surgical time, blood loss, hospital stay, and complications were recorded. The anatomical cure rate was evaluated according to the Pelvic Organ Prolapse Questionnaire (POP-Q) assessment. Validated questionnaires of the Pelvic Floor Distress Inventory (PFDI-20) and the Pelvic Floor Impact Questionnaire (PFIQ-7) were recorded to evaluate the symptom severity and quality of life.
The mean duration of follow-up was 15 months. All domains of POP-Q, PFDI-20, and PFIQ-7 scores improved significantly after surgery. No major complications, mesh exposure, or mesh complication occurred during the follow-up period.
The overall repair concept of laparoscopic pectopexy as the core, assisted by vaginal natural tissue repair for severe pelvic organ prolapse can achieve satisfactory clinical results and improve patient satisfaction.
目前，用于阴道修复的网片存在问题；因此，人们对天然组织修复的兴趣日益增加。将天然组织修复与足够的网片应用于顶端修复相结合，可能提供有效的治疗方法。我们描述了一项专注于联合进行耻骨固定术和天然组织修复的研究。
在 2020 年 4 月至 2021 年 11 月期间，对 49 例有症状的 III 期或 IV 期患者采用腹腔镜耻骨固定术联合天然组织修复进行治疗。该网片仅用于顶端修复。所有其他具有临床相关性的缺陷均采用天然组织修复进行治疗。记录了包括手术时间、出血量、住院时间和并发症在内的围手术期参数。根据盆腔器官脱垂问卷（POP-Q）评估来评估解剖学治愈率。记录了经过验证的盆腔器官脱垂生活质量问卷（PFDI-20）和盆腔器官脱垂影响问卷（PFIQ-7）的问卷，以评估症状严重程度和生活质量。
平均随访时间为 15 个月。POP-Q、PFDI-20 和 PFIQ-7 的所有领域评分在手术后均显著改善。在随访期间，未发生重大并发症、网片暴露或网片并发症。
以腹腔镜耻骨固定术为核心，辅以阴道天然组织修复治疗严重盆腔器官脱垂的整体修复概念，可以获得满意的临床效果并提高患者满意度。
