改良经脐单孔腹腔镜阴道残端骶前固定术在治疗盆底器官脱垂中的应用研究

Application of modified transumbilical single-port laparoscopic vaginal stump sacral fixation in the treatment of pelvic floor organ prolapse

目的探讨改良经脐单孔腹腔镜阴道残端骶前固定术治疗盆腔器官脱垂与传统腹腔镜阴道残端骶前固定术治疗盆底器官脱垂相比的安全性及优势。方法回顾性分析2020年12月—2023年4月因盆底器官脱垂在苏州大学附属独墅湖医院行腹腔镜下阴道残端骶前固定术的患者的临床资料,根据手术方法分为改良单孔腹腔镜组(9例)和传统腹腔镜组(10例),比较一般人口学资料[年龄、体重质量指数(body mass index,BMI)、绝经年龄、孕次]以及手术相关情况(手术时间、术中出血量、术前血红蛋白与术后血红蛋白的差值、术后疼痛评分等)。结果改良经脐单孔腹腔镜组与传统腹腔镜组相比,年龄、绝经年龄、孕次、BMI,差异均无统计学意义(P>0.05)。两组相比,手术时长、手术中的出血量、术前术后血红蛋白差值、术后排气时间、术后保留导尿时间、术后并发症、术后住院时间及住院费用,差异无统计学意义(P>0.05)。术后疼痛评分差异有统计学意义(P<0.05)。结论改良经脐单孔腹腔镜阴道残端骶前固定术与传统腹腔镜阴道残端骶前固定术治疗盆底器官脱垂相比,能减轻患者术后疼痛,且安全性相当。

Objective To investigate the safety and advantages of modified transumbilical single-port laparoscopic vaginal stump sacral colpopexy for pelvic organ prolapse compared with conventional laparoscopic vaginal stump sacral colpopexy for pelvic floor organ prolapse.Methods We retrospectively analyzed the clinical data of patients who underwent laparoscopic sacral colpopexy of the vaginal stump at Dushu Lake Hospital affiliated to Soochow University for pelvic organ prolapse from December 2020 to April 2023.They were divided into a modified transumbilical single-port laparoscopic group(9 cases)and a conventional laparoscopic group(10 cases)according to the surgical method,and were compared in general demographic data(age,BMI,age at menopause,number of pregnancies)and surgery-related conditions(operative time,intraoperative bleeding,preoperative Hb-postoperative Hb,postoperative pain score,etc.).Results There were no statistically significant differences in age,age at menopause,pregnancy frequency,or BMI between the modified transumbilical single-port laparoscopy group and the conventional laparoscopy group(P>0.05).There were no statistically significant differences in the length of surgery,intraoperative bleeding,difference between preoperative and postoperative hemoglobin levels,postoperative venting time,postoperative retention of catheterization time,postoperative complications,time from surgery to discharge,and hospitalization costs between the two groups(P>0.05).The difference in postoperative pain scores was statistically significant,and the modified transumbilical single-port laparoscopic group had less pain than the multi-port group(P<0.05).Conclusion Modified transumbilical single-port laparoscopic sacral colpopexy of the vaginal stump can reduce postoperative pain in patients with a similar safety profile compared with conventional laparoscopic sacral colpopexy of the vaginal stump for pelvic organ prolapse.