腹腔镜阴道骶骨固定术治疗盆腔器官脱垂的疗效评价

目的:评价腹腔镜阴道骶骨固定术(LSC)治疗盆腔器官脱垂的临床疗效。方法:2009年1月至2015年5月对100例中盆腔缺陷为主的盆腔器官脱垂患者行LSC,分离右侧盆腔后腹膜,将网片远端固定于阴道前后壁、阴道穹隆;近端网片固定于骶前纵韧带,网片无张力置于腹膜后。采用手术成功、手术并发症及盆底功能障碍问卷(pelvic floor distress inventory-short form 20,PFDI-20)评价疗效。结果:手术时间165.7±48.0分钟,术中出血量119.5±108.5 ml。术后留置尿管时间4.3±2.4天,排便时间4.7±1.3天,住院9.6±3.6天。手术均成功,无复发病例,新发尿失禁17例。术后并发症共12例,包括暂时性尿潴留1例,肠梗阻3例,发热1例,术后网片侵蚀6例,术后右下腹坠痛再次手术网片取出术1例。100例随访31.9±17.6月。PFDI-20术后评分较术前有显著性差异(3.46±3.56分vs 17.98±8.24分,P0.001)。结论:LSC治疗中盆腔缺陷为主的盆腔器官脱垂,安全,效果好,能显著改善患者盆底功能障碍症状。

The Clinical Evaluation of Laparoscopic Sacral Colpopexy for the Patient with Pelvic Organ Prolapse

Objective:To evaluate the clinical efficacy of laparoscopic sacral colpopexy for the treatment of pelvic organ prolapse.Methods:The clinical data of 100 cases (2009.01-2015.05) of laparoscopic sacral colpopexy for the patients with pelvic organ prolapse were retrospectively analyzed.Evaluations were performed by successful rate,complications and pelvic floor distress inventory-short form 20 (PFDI-20).Results:Mean operating time was 165.7 ±48.0 min.Blood loss during operation was 119.5 ± 108.5 ml.Indwelling catheter time,Defecation time and hospital staying were 4.3 ±2.4 days,4.7 ± 1.3 days and 9.6 ±3.6 days,respectively.No operation failure and relapse,new urinary incontinence were 17 case in this study.The complications included transient urinary retention (1 case),intestinal obstruction (3 cases),fever (1 case),mesh erosion (6 cases),removing mesh due to abdomen pain(1 case).100 patients were underwent laparoscopic sacral colpopexy and follow-up rate was 100％.The follow-up time was 31.9 ± 17.6 months.Postoperation score of PFDI-20 questionnaire improved significantly than preoperation (3.46 ±3.56 vs 17.98 ±8.24,P ＜0.001).Conclusions:Laparoscopic sacral colpopexy is effective and safe for the patient with pelvic organ prolapse,especially for the atypical defect.It can significantly improve the life quality of patients.