Saidi M H, Gallagher M S, Skop I P, Saidi J A, Sadler R K, Diaz K C
Department of Obstetrics and Gynecology, The University of Texas Health Science Center at San Antonio, USA.
Obstet Gynecol. 1998 Oct;92(4 Pt 1):619-21. doi: 10.1016/s0029-7844(98)00266-x.
To compare duration of surgery, length of hospital stay, complications, and short-term cure rate of extraperitoneal laparoscopic colposuspension with that of Burch colposuspension.
We retrospectively reviewed 157 consecutive cases of extraperitoneal laparoscopic (n=70) or Burch colposuspension (n=87) performed between January 1, 1995, and June 30, 1997. Cure rate was assessed by history, physical examination, and questionnaire. Patients not requiring the use of pads were considered continent. Cure rates were compared in the entire group, whereas complications, duration of surgery, and length of stay were compared only in subgroups undergoing colposuspension alone. Results were analyzed statistically.
The mean times to follow-up were 12.9 months (laparoscopic group) and 16.3 months (Burch group). At last follow-up, 64 of 70 (91.4%) of the laparoscopic and 80 of 87 (92%) of the Burch colposuspension group were continent. In patients who underwent colposuspension alone, results were as follows for those who underwent laparoscopic (19) and Burch (21) procedures, respectively: average duration of surgery, 49.2 compared with 62.6 minutes (P < .03); average hospital stay, 14 hours compared with 2.7 days (P < .001); average postoperative disability period, 1.6 weeks compared with 4.7 weeks (P < .001); incidence of complications, 15.8% compared with 33.3% (P=.170).
Extraperitoneal laparoscopic colposuspension, compared with Burch colposuspension, resulted in similar short-term cure rates and complications, shorter duration of surgery, hospital stay, and convalescence. It is a feasible option in treatment of stress urinary incontinence when laparotomy is not required.
比较腹膜外腹腔镜膀胱颈悬吊术与Burch膀胱颈悬吊术的手术时间、住院时间、并发症及短期治愈率。
我们回顾性分析了1995年1月1日至1997年6月30日期间连续进行的157例腹膜外腹腔镜手术（n = 70）或Burch膀胱颈悬吊术（n = 87）病例。通过病史、体格检查和问卷调查评估治愈率。不需要使用护垫的患者被视为控尿良好。在整个组中比较治愈率，而仅在单独接受膀胱颈悬吊术的亚组中比较并发症、手术时间和住院时间。对结果进行统计学分析。
腹腔镜组平均随访时间为12.9个月，Burch组为16.3个月。在最后一次随访时，腹腔镜膀胱颈悬吊术组70例中的64例（91.4%）和Burch膀胱颈悬吊术组87例中的80例（92%）控尿良好。在单独接受膀胱颈悬吊术的患者中，接受腹腔镜手术（19例）和Burch手术（21例）的患者结果如下：平均手术时间分别为49.2分钟和62.6分钟（P <.03）；平均住院时间分别为14小时和2.7天（P <.001）；平均术后残疾期分别为1.6周和4.7周（P <.001）；并发症发生率分别为15.8%和33.3%（P =.170）。
与Burch膀胱颈悬吊术相比，腹膜外腹腔镜膀胱颈悬吊术的短期治愈率和并发症相似，但手术时间、住院时间和康复时间更短。在不需要开腹手术的情况下，它是治疗压力性尿失禁的一种可行选择。
