Peters W A, Christenson M L
Department of Obstetrics and Gynecology, Swedish Hospital Medical Center, Seattle, Washington, USA.
Am J Obstet Gynecol. 1995 Jun;172(6):1894-900; discussion 1900-2. doi: 10.1016/0002-9378(95)91429-3.
This study was undertaken to compare the effectiveness of fixation of the vaginal apex to the coccygeus fascia with fixation to the sacrospinous ligament during surgical repair of vaginal vault eversion with enterocele.
The records of 121 patients with posthysterectomy vaginal vault eversion with enterocele treated by the author between 1983 and 1994 were reviewed. Preoperative and postoperative symptoms and findings on pelvic examination and postoperative recovery were compared in patients undergoing sacrospinous ligament suspension and coccygeus fascial suspension. Statistical analysis was performed with chi 2 analysis and Kaplan-Meier life tables.
Eighty-one patients underwent fixation to the coccygeus fascia and 30 underwent sacrospinous ligament suspension. The two groups are similar for clinical history, symptoms, and findings on pelvic examination. Ten patients underwent an abdominal sacral colpopexy for specific indications and are not comparable. The incidence of postoperative complications and length of hospital stay were similar for the two vaginal procedures. Patients with coccygeus fascial suspension have a projected 96% cure rate at 2 years compared with an 80% cure rate for patients with a sacrospinous ligament suspension.
Bilateral vaginal vault suspension to the coccygeus fascia is a safe, simple, and effective technique in the management of vaginal vault eversion with enterocele.
本研究旨在比较在伴有小肠膨出的阴道穹隆脱垂手术修复过程中，将阴道顶端固定于尾骨肌筋膜与固定于骶棘韧带的有效性。
回顾了作者在1983年至1994年间治疗的121例子宫切除术后伴有小肠膨出的阴道穹隆脱垂患者的记录。对接受骶棘韧带悬吊术和尾骨肌筋膜悬吊术的患者，比较其术前和术后症状、盆腔检查结果以及术后恢复情况。采用卡方分析和Kaplan-Meier生存表进行统计分析。
81例患者接受了尾骨肌筋膜固定术，30例接受了骶棘韧带悬吊术。两组在临床病史、症状和盆腔检查结果方面相似。10例患者因特定指征接受了腹骶阴道固定术，不具有可比性。两种阴道手术的术后并发症发生率和住院时间相似。尾骨肌筋膜悬吊术患者在2年时的预计治愈率为96%，而骶棘韧带悬吊术患者为80%。
双侧阴道穹隆悬吊至尾骨肌筋膜是治疗伴有小肠膨出的阴道穹隆脱垂的一种安全、简单且有效的技术。
