腹腔镜下非网片盆底重建术治疗盆腔脏器脱垂的疗效分析

Clinical efficacy of laparoscopic non-mesh reconstruction of pelvic floor in pelvic organ prolapse

目的 观察腹腔镜下非网片治疗盆腔脏器脱垂的疗效和安全性.方法 87例Ⅲ~Ⅳ度盆腔脏器脱垂患者分别采用腹腔镜全子宫切除术联合阴道修补术及不吸收线骶骨固定术(研究组,42例)或聚丙烯网片阴道骶骨固定术(对照组,45例).比较两组手术时间、出血量、阴道长度、留置尿管时间、住院时间、住院费用和客观治愈率.结果 研究组术中出血量多于对照组,住院费用低于对照组(P<0.01或0.05);手术时间、阴道长度、留置尿管时间、住院时间差异无统计学意义(P>0.05).术后3、6、12个月随访,两组客观治愈率均为100.0%.研究组无异物感,对照组3例出现盆腔异物感和烧灼感.结论 腹腔镜下非网片盆底重建术治疗中盆腔脱垂操作简单、疗效好、费用低.

Objective To observe the effectiveness and safety of laparoscopic non-mesh reconstruction of pelvic floor in pelvic organ prolapse(POP). Methods Eighty-seven patients with stage Ⅲ ~Ⅳ POP were treated with laparoscopic panhysterectomy plus vaginal repair and sacral colpopexy with nonabsorbable suture(study group, n=42) or sacral colpopexy with polypropylene mesh(control group, n=45). Operation time, bleeding volume, vagina length, indwelling time, hospital stay and costs, and objective cure rate were compared between two groups. Results Intraoperative blood loss was higher, while hospital costs were lower in study group compared to control group(P<0.01 or 0.05). There was no significant differences in operation time, vagina length, indwelling time and hospital stay between two groups(P>0.05). The Objective cure rates in both groups were 100% at follow-up of 3, 6 and 12 months. Foreign body and burning sensation occurred in 3 cases of control group, but lacked in study group. Conclusion Laparoscopic non-mesh reconstruction of pelvic floor is simple, effective and inexpensive for POP.