腹腔镜骶骨岬悬吊术治疗盆腔脏器脱垂可行性研究

目的 探讨腹腔镜骶骨岬悬吊术治疗盆腔脏器脱垂的可行性及疗效.方法 采用腹腔镜骶骨岬悬吊术治疗盆腔脏器脱垂的经产妇45例,术中置入网片（MESH）进行固定.结果 45例经产女均经腹腔镜下完成手术,其中5例同时行子宫全切术,8例同时行子宫次全切术,1例同时行子宫肌瘤剔除,10例同时行阴道后壁修补,1例同时行尿道中段库柏式韧带悬吊术,均无中转开腹.手术时间70～180min,术中出血30～300ml.术后随访时间6～82个月,均无脱垂复发.1例术后发生1度张力性尿失禁,1例发生MESH感染,1例因发生阴道糜烂后取出MESH.其中19例术后3个月性生活无明显不适.结论 腹腔镜骶骨岬悬吊术治疗盆腔脏器脱垂是安全、有效的,提高手术技巧和选择合适的MESH可减少MESH相关并发症.

Laparoscopic promontofixation for treatment of pelvic organ prolapse

Objective To evaluate the efficacy of laparoscopic promontofixation for treatment of pelvic organ prolapse. Methods Forty five women with pelvic organ prolapse underwent laparoscopic promontofixation. Results All procedures were successfully completed laparoscopically. Five patients had simultaneous total hysterectomy; 8 had simultaneous supracervical hysterectomy; 1 had simultaneous myomectomy and 1 had concurrent Butch colposuspension. The range of operating time was 70-180 min, and the range of blood loss was 30-300 ml. The range of follow-up was 6-82 months. There was no recurrence of prolapse of the same position till now. One patient had 1° stress urinary incontinence. One patient had mesh infection. Transvaginal removal of the entire mesh took place in 1 patient with vaginal erosion. Nineteen patients had sexual activity 3 months after the operation and no patients complained of sexual dysfunction. Conclusion The laparoscopic promontofixation hysteropexy or colpopexy is a effective and safe surgical procedure in the management of pelvic organ prolapse. Improving surgical techniques and using ideal mesh can reduce risks of mesh-related complications.