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腹腔镜网状物侧方悬吊术治疗重度盆腔前部和顶端器官脱垂:一项为期2年随访的安全性和有效性观察性队列研究

Laparoscopic lateral suspension with mesh for severe anterior and apical pelvic organ prolapse: an observational cohort study for safety and efficacy at 2-year follow-up.

作者信息

Wang Xiao-Xiao, Xu Ying, Song Yan-Feng, Lin Chao-Qin, Jiang Xiao-Xiang

机构信息

Department of Obstetrics and Gynecology, Fujian Maternity and Child Health Hospital, 18 Dao-Shan Road, Fuzhou, 350108, Fujian, China.

Department of Obstetrics and Gynecology, the 900th Hospital of Joint Logistic Support Force, Fuzhou, Fujian, China.

出版信息

Arch Gynecol Obstet. 2024 Dec;310(6):3259-3265. doi: 10.1007/s00404-024-07792-9. Epub 2024 Oct 23.

Abstract

PURPOSE

This study aimed to investigate the clinical safety and efficacy of laparoscopic lateral suspension (LLS) with mesh in the treatment of severe anterior and apical pelvic organ prolapse (POP) Chinese women with a 2-year follow-up.

METHODS

We conducted an observational cohort study. Sixty patients who presented apical (uterovaginal or vault) and anterior prolapse at stage 3 or higher were enrolled. The LLS surgical procedure was performed in accordance with Dubuisson standard operation. The objective and subjective cures as well as the surgery-related complications were evaluated. The POP-related questionnaires were used to evaluate the quality of life before operation and at 24 months after operation follow-up.

RESULTS

Objective cure rates at 2 years of follow-up were 88.3% for the anterior compartment, 100% for the apical compartment and 93.3% for the posterior compartment. The subjective cure rate reached to 93.3%. There were statistically significant lower scores of the pelvic floor impact questionnaire-7 (PFIQ-7) and the pelvic floor distress inventory-short form-20 (PFDI-20) for all women after surgery and they exhibited similar scores of the pelvic organ prolapsed-urinary incontinence sexual questionnaire-12 (PISQ-12) (P = 0.317). And no significant difference was demonstrated in international consultation on the incontinent questionnaire short form (ICI-Q-SF) (P = 0.551). No major complications associated with LLS were observed in our study.

CONCLUSION

We consider that LLS with mesh operation is safe, feasible and effective to correct severe apical and anterior POP after 2-year follow-up.

摘要

目的

本研究旨在探讨腹腔镜网片侧方悬吊术(LLS)治疗中国重度前盆腔和顶端盆腔器官脱垂(POP)女性患者的临床安全性和疗效,并进行为期2年的随访。

方法

我们开展了一项观察性队列研究。纳入60例顶端(子宫阴道或穹窿)和前壁脱垂达3期或更高分期的患者。LLS手术按照迪布瓦松标准操作进行。评估客观和主观治愈率以及手术相关并发症。采用POP相关问卷评估术前及术后24个月随访时的生活质量。

结果

随访2年时,前盆腔的客观治愈率为88.3%,顶端盆腔为100%,后盆腔为93.3%。主观治愈率达93.3%。所有女性术后盆底影响问卷-7(PFIQ-7)和盆底困扰量表简表-20(PFDI-20)得分均有统计学意义的降低,且她们的盆腔器官脱垂-尿失禁-性功能问卷-12(PISQ-12)得分相似(P = 0.317)。国际尿失禁咨询委员会简表(ICI-Q-SF)无显著差异(P = 0.551)。本研究未观察到与LLS相关的严重并发症。

结论

我们认为,经2年随访,LLS联合网片手术治疗重度顶端和前壁POP安全、可行且有效。

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