腹腔镜骶前神经切断术治疗慢性盆腔痛21例临床分析

Role of Laparoscopic Presacral Neurectomy for the Treatment of Chronic Pelvic Pain

目的评价腹腔镜骶前神经切断术对各类慢性盆腔痛的治疗效果及安全性。方法行骶前神经切断术的慢性盆腔痛患者21例，年龄23～50岁。其中，慢性盆腔炎8例，子宫内膜异位症10例，盆腔瘀血症3例。结果本组患者行骶前神经切断术的手术时间为45～95min（平均68min），手术中出血量55～150ml（平均86d），肛门排气时间为9～25h（平均14h），住院时间4～7d（平均5．3d）。随访时间5～14个月（平均8个月），疼痛消失14例，缓解5例，无效2例。结论对慢性盆腔痛，腹腔镜骶前神经切断术是一种比较有效的治疗方法，具有一定的临床可行性。

Objective To evaluate the efficacy and safety of laparoscopic presacral neurectomy （LPSN） as the surgical treatment of chronic pelvic pain. Methods 21 women were experienced severe pelvic pain, in which 8 had chronic pelvic inflammatory disease, 10 endometriasis and other 3 pelvic congestion syndrome. All patients were performed laparescopie presacral neurectomy. Results All patients were underwent technically successful laparoscopie presaeral neurectomy without intraoperative and postoperative complications. Average operating time was 68 min （45 - 95 min） and average blood loss was 86 ml （55 - 150 ml） respectively.The time of evacuate gas was 14 h （9 - 25 h）. Postoperative hospital stay was 5.3 d （4 - 7 d）. Followed up 5 to 14 months after surgery, 14 patients were disappeared of pain, 5 significant reduction of pain and 2 inefficacy. Conclusion Presaeral neurectomy can be performed safely and efficiently by laparoscopy and is a valuable alternative treatment for chronic pelvic pain.