改良腹腔镜高位骶韧带悬吊术在重度中盆腔脱垂的中期疗效评价

Intermediate-term outcomes of modified laparoscopic high uterosacral ligament suspension in advanced pelvic organ prolapse

目的评价改良腹腔镜高位骶韧带悬吊术在重度中盆腔脱垂的中期疗效。方法纳入2017年11月-2020年12月在甘肃省妇幼保健院因中盆腔脱垂Ⅲ度、Ⅳ度行改良腹腔镜高位骶韧带悬吊术41例患者,术后以门诊检查及电话随访及问卷评价疗效。结果术后6、12个月与术前相比,Aa、Ba、C均显著改善,差异有统计学意义(P<0.05);术后6、12个月盆底疾病生命质量影响问卷和盆底功能障碍问卷评分均较术前均改善,差异有统计学意义(P<0.05);随访(32.44±11.10)个月,复发率19.51%,再手术率2.44%,缝线暴露率14.63%,整体印象改善评分量表总体满意度92.68%。结论针对重度中盆腔脱垂,改良腹腔镜高位骶韧带悬吊术能达到解剖学的整体改善,有效改善患者生活质量,但合并重度前盆腔脱垂者复发率高。

Objective To evaluate the outcomes of modified laparoscopic high uterosacral ligament suspension in advanced pelvic organ prolapse in intermediate term.Methods On 41 patients with advanced pelvic organ prolapse who underwent modified laparoscopic high uterosacral ligament suspension between November 2017 and December 2020.Only symptomatic uterine or vaginal vault prolapse patients with stageⅢ,Ⅳwere included.After the operation,we used the outpatient and telephone follow-up and questionnaires to evaluate cases.Results After 6 months and 12 months,points(Aa,Ba,C)were all improved(P<0.05).The scores of pelvic floor impact questionnaire short form 7 and pelvic floor distress inventory-short form 20 were improved,seperately(P<0.05).After(32.44±11.10)months follow-up,the recurrence rate was 19.51%,reoperation rate was 2.44%,suture erosion rate were 14.63%,patient global impression of improvement scale was 92.68%.Conclusion Modified laparoscopic high uterosacral ligament suspension is efficacious for patients with advanced pelvic organ prolapse of the middle compartment.But patients with concomitant advanced anterior compartment had a high anatomical cystocele recurrence rate.