Gold Ronen S, Neuman Jonatan, Baruch Yoav, Neuman Menahem, Groutz Asnat
Urogynecology Unit, Department of Obstetrics and Gynecology, Lis Maternity and Women's Hospital, Tel-Aviv Medical Center, Medical School, Tel Aviv University, Tel-Aviv 6423906, Israel.
Medical School, Semmelweis University, 1085 Budapest, Hungary.
J Clin Med. 2024 Sep 18;13(18):5520. doi: 10.3390/jcm13185520.
This study aimed to evaluate the safety and efficacy of minimally invasive sacrospinous ligament (SSL) fixation of apical pelvic organ prolapse (POP) in older patients compared to younger patients. A cohort of 271 older (≥65 years) patients (mean age 71.8 ± 5.2 years) and 60 younger patients (mean age 47.6 ± 7.1 years) with stage III or IV apical POP who underwent SSL fixation by the EnPlace device was retrospectively analyzed. The age range of older patients was further divided into early old (65-74 y, N = 209), old (75-84 y, N = 58), and late old (>85 y, N = 4). Patient characteristics, surgical safety, and 6-month postoperative outcomes were compared between the four age groups. Duration of surgery and blood loss were similar among all age groups. Most patients (99.4%) were discharged on the day of surgery or the day after. Subjective patient satisfaction rates were high among all patients. Point C measurements at six months postoperatively were less favorable among the younger patients. Furthermore, four (6.7%) younger patients versus six (2.2%) older patients required surgical repair of recurrent apical POP within the follow-up period. The short-term outcomes of minimally invasive SSL fixation suggest that it is a safe and effective procedure for significant apical POP repair among older patients.
本研究旨在评估与年轻患者相比，老年患者行微创骶棘韧带（SSL）固定术治疗盆腔器官顶端脱垂（POP）的安全性和有效性。回顾性分析了一组271例年龄较大（≥65岁）患者（平均年龄71.8±5.2岁）和60例年轻患者（平均年龄47.6±7.1岁），这些患者均为Ⅲ期或Ⅳ期盆腔器官顶端脱垂且接受了EnPlace装置的SSL固定术。年龄较大患者的年龄范围进一步分为老年前期（65 - 74岁，N = 209）、老年期（75 - 84岁，N = 58）和高龄期（>85岁，N = 4）。比较了这四个年龄组的患者特征、手术安全性及术后6个月的结局。所有年龄组的手术时间和失血量相似。大多数患者（99.4%）在手术当天或术后第一天出院。所有患者的主观满意度都很高。年轻患者术后6个月的C点测量结果较差。此外，在随访期内，4例（6.7%）年轻患者与6例（2.2%）老年患者需要对复发性盆腔器官顶端脱垂进行手术修复。微创SSL固定术的短期结果表明，对于老年患者严重盆腔器官顶端脱垂的修复，该手术是一种安全有效的方法。
