Chen Pei-Chen, Tsui Wing Lam, Ding Dah-Ching
Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan.
Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan.
Tzu Chi Med J. 2024 Apr 24;36(4):412-417. doi: 10.4103/tcmj.tcmj_237_23. eCollection 2024 Oct-Dec.
This study compared the surgical outcomes of anterior vaginal wall repair (A-repair) and paravaginal repair (PVR) for laparoscopic pelvic organ prolapse (POP) surgeries.
This retrospective case-control study recruited patients who underwent laparoscopic POP surgeries in our hospital from May 1, 2013, to May 31, 2022, using the health insurance surgical code payment system (laparoscopic colpopexy/hysteropexy/cervicopexy: 80025B) in Taiwan. The patients were divided into A-repair (group 1) and PVR (group 2). Patients aged <20 years, without postoperative outcomes, and without baseline characteristics were excluded. Baseline characteristics (age, menopausal status, parity, diabetes mellitus, and hypertension) were collected. The outcome was to compare the changes in Pelvic Organ Prolapse Quantification (POP-Q) scores (Aa, Ba, and total vaginal length) preoperatively and 1-2 months, 3-6 months, and 1 year postoperatively in the two groups.
After exclusion, 23 and 10 patients in A-repair and PVR, respectively, were recruited. There was no significant difference in baseline characteristics between the two groups. Patients in both groups showed significant improvement in Aa and Ba of POP-Q 1-2 months and 3-6 months postoperatively, except for those in group 2 1 year postoperatively. However, there was no significant difference in postoperative scores between the two groups at 1-2 months, 3-6 months, and 1 year postoperatively. The estimated blood loss did not exhibit a significant difference between the two groups; however, PVR had a longer duration of operation.
The surgical outcomes of A-repair and PVR for the anterior compartment were comparable at 1-2 months, 3-6 months, and 1 year postoperatively.
本研究比较了腹腔镜盆腔器官脱垂(POP)手术中行阴道前壁修补术(A修补术)和阴道旁修补术(PVR)的手术效果。
本回顾性病例对照研究纳入了2013年5月1日至2022年5月31日在我院接受腹腔镜POP手术的患者,采用台湾地区健康保险手术编码支付系统(腹腔镜阴道固定术/子宫固定术/宫颈固定术:80025B)。患者分为A修补术组(第1组)和PVR组(第2组)。排除年龄<20岁、无术后结果及无基线特征的患者。收集基线特征(年龄、绝经状态、产次、糖尿病和高血压)。结果是比较两组术前以及术后1 - 2个月、3 - 6个月和1年时盆腔器官脱垂定量(POP - Q)评分(Aa、Ba和阴道总长度)的变化。
排除后,分别招募了23例接受A修补术的患者和10例接受PVR的患者。两组的基线特征无显著差异。两组患者术后1 - 2个月和3 - 6个月时POP - Q的Aa和Ba均有显著改善,但第2组患者术后1年时除外。然而,两组术后1 - 2个月、3 - 6个月和1年时的评分无显著差异。两组间估计失血量无显著差异;然而,PVR的手术时间更长。
术后1 - 2个月、3 - 6个月和1年时,A修补术和PVR治疗前盆腔的手术效果相当。