Guo L S, Zheng L J, Dai S R, Zhang S J
Department of Obstetrics and Gynecology, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China.
Department of Ultrasound, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China.
Zhonghua Yi Xue Za Zhi. 2023 Sep 26;103(36):2889-2892. doi: 10.3760/cma.j.cn112137-20221230-02737.
To investigate the feasibility and safety of the Lasso suture hook in transvaginal sacrospinous ligament fixation, a total of 38 patients with vaginal vault prolapse at or above stage Ⅱ, and aged 46-75(62.7±12.5)years, who underwent transvaginal sacrospinous ligament fixation at the Second Affiliated Hospital of Soochow University from January 2018 to January 2021 were retrospectively analyzed. After complete exposure of the right sacrospinous ligament, the cervical/uterosacral ligament was sutured to the sacrospinous ligament using Lasso hook and polypropylene sutures. The completion rate of the operation, intraoperative complications, operation time, blood loss, and postoperative situations were observed, and the objective cure rate and subjective satisfaction were followed up. Transvaginal sacrospinous ligament fixation was successfully performed in all 38 patients using Lasso suture hooks. There were no bladder or rectum injuries during the operations, and no pelvic hematoma occurred. The operation time was 15-40 (24±9.5) min; the intraoperative bleeding was 20-60 (40±12.5) ml; the visual analogue scale(VAS)score was 3-5 (3.2±1.4) points on the first day of postoperative, and 2-4 (2.2±1.8) points on the third day of postoperative. No numbness or pain in buttocks and lower limbs after the operation. The 3-month follow-up results showed that the objective surgical success rate of the postoperative pelvic organ prolapse quantitation (POP-Q) score was 100% (38/38). The 1-year follow-up results showed that the objective surgical cure rate of postoperative POP-Q score was 92.1% (35/38). The score of Pelvic Floor Distress Inventory-Short Form 20 (PFDI-20)was 42-180(120.4±44.9)before operation and 8-75 (28.0±14.3) after operation(=15.90, <0.001); The score of Pelvic Floor Function Impact Questionnaire-Short Form7 (PFIQ-7) was 52-214(112.8±44.5)before operation and 5-29 (14.3±6.0) after operation (=14.40, <0.001), and the subjective satisfaction rate is 89.5% (34/38) conducted by Patient Global Impression of Improvement (PGI-I). Transvaginal sacrospinous ligament fixation with Lasso suture hook is simple, safe, and feasible.
为探讨套索缝合钩在经阴道骶棘韧带固定术中的可行性及安全性，回顾性分析2018年1月至2021年1月在苏州大学附属第二医院接受经阴道骶棘韧带固定术的38例Ⅱ期及以上阴道穹窿脱垂患者，年龄46 - 75（62.7±12.5）岁。充分暴露右侧骶棘韧带后，使用套索钩和聚丙烯缝线将宫颈/子宫骶韧带缝合至骶棘韧带。观察手术完成率、术中并发症、手术时间、出血量及术后情况，并随访客观治愈率和主观满意度。38例患者均使用套索缝合钩成功完成经阴道骶棘韧带固定术。术中无膀胱或直肠损伤，未发生盆腔血肿。手术时间为15 - 40（24±9.5）分钟；术中出血20 - 60（40±12.5）毫升；术后第1天视觉模拟评分（VAS）为3 - 5（3.2±1.4）分，术后第3天为2 - 4（2.2±1.8）分。术后无臀部及下肢麻木或疼痛。3个月随访结果显示，术后盆腔器官脱垂定量（POP - Q）评分的客观手术成功率为100%（38/38）。1年随访结果显示，术后POP - Q评分的客观手术治愈率为92.1%（35/38）。盆底功能障碍量表简表20（PFDI - 20）术前评分为42 - 180（120.4±44.9），术后为8 - 75（28.0±14.3）（=15.90，<0.001）；盆底功能影响问卷简表7（PFIQ - 7）术前评分为52 - 214（112.8±44.5），术后为5 - 29（14.3±6.0）（=14.4 /span>0，<0.001），患者整体改善印象（PGI - I）主观满意率为89.5%（34/38）。使用套索缝合钩行经阴道骶棘韧带固定术简单、安全、可行。
