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经阴道 EnPlace 骶棘韧带固定术——一种治疗阴道顶端盆腔器官脱垂的新型微创经阴道手术:安全性和短期结果。

The EnPlace sacrospinous ligament fixation-A novel minimally invasive transvaginal procedure for apical pelvic organ prolapse repair: Safety and short-term outcome results.

机构信息

Urogynecology Unit, Department of Obstetrics and Gynecology, Lis Women Hospital, Tel Aviv Medical Center, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

The Urogynecology Service, Assuta Medical Centers, Faculty of Health Sciences, Ben Gurion University, Beer Sheva, Israel.

出版信息

Int J Gynaecol Obstet. 2023 Nov;163(2):667-671. doi: 10.1002/ijgo.14927. Epub 2023 Jun 20.

Abstract

OBJECTIVE

The EnPlace device is a novel minimally invasive tool allowing transvaginal sacrospinous ligament (SSL) fixation of apical pelvic organ prolapse (POP). The study aimed to investigate the safety and short-term efficacy of the EnPlace SSL fixation for significant apical POP repair.

METHODS

A retrospective cohort study of 123 consecutive patients (mean age 64.4 ± 11.1 years) with stage III or IV apical POP who underwent SSL fixation by the EnPlace device. Safety and 6-month outcome results were analyzed and compared between 91 (74%) patients with uterine prolapse versus 32 (26%) patients with vaginal vault prolapse.

RESULTS

There were no intraoperative or early postoperative complications. The mean (± standard deviation) duration of surgery was 30 ± 6.9 min and mean blood loss was 30.5 ± 18.5 mL. The average position of point C by POP-Quantification measurements before surgery and at 6 months postoperatively was 4.5 ± 2.8 cm and -3.1 ± 3.3 cm, respectively. Of 91 patients with preoperative uterine prolapse, eight (8.8%) patients developed a recurrent uterine prolapse within 6 months postoperatively. Of 32 patients with preoperative vault prolapse, two patients (6.3%) had recurrent vault prolapse.

CONCLUSION

Short-term outcome results of EnPlace SSL fixation suggest that it is a safe and effective minimally invasive transvaginal procedure for significant apical POP repair.

摘要

目的

EnPlace 装置是一种新型微创工具,可通过阴道实现骶棘韧带(SSL)固定术,从而治疗严重的盆腔器官脱垂(POP)。本研究旨在探讨 EnPlace SSL 固定术治疗中重度盆腔器官脱垂的安全性和短期疗效。

方法

回顾性队列研究纳入了 123 例连续的 III 或 IV 度中重度盆腔器官脱垂患者(平均年龄 64.4±11.1 岁),采用 EnPlace 装置行 SSL 固定术。分析并比较了 91 例(74%)伴子宫脱垂患者与 32 例(26%)伴阴道穹隆脱垂患者的安全性和 6 个月的结局。

结果

术中及术后早期均无并发症发生。手术时间的平均(±标准差)为 30±6.9 分钟,平均出血量为 30.5±18.5 毫升。POP-Q 测量术前和术后 6 个月时的 C 点平均位置分别为 4.5±2.8 厘米和-3.1±3.3 厘米。91 例术前伴子宫脱垂的患者中,8 例(8.8%)在术后 6 个月内出现复发性子宫脱垂。32 例术前伴阴道穹隆脱垂的患者中,2 例(6.3%)出现复发性阴道穹隆脱垂。

结论

EnPlace SSL 固定术的短期结局提示,该术式是治疗中重度盆腔器官脱垂的一种安全有效的微创阴道手术。

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