腹腔与腹腔镜骶骨阴道固定术的比较研究

Ahmed Samy El-agwany, Hisham Abdelfatah Salem, Ahmed Mohammed Nagaty, Tamer Mahmoud Hanafy
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引用次数: 3

摘要

本研究旨在比较腹腔镜下和开放式骶骨阴道固定术的有效性和安全性。这项前瞻性随机对照研究在埃及亚历山大大学El-Shatby妇产医院妇科进行。它涉及30名女性,在符合纳入研究的标准并知情同意后选择参加研究。本研究中所有患者被随机分为以下两组之一:A组(15例),行腹腔镜骶colpop固定术。B组(15例)行腹腔(开放式)骶骶固定术。回顾了人口统计和医院数据、并发症和随访。腹腔镜组和开放组的中位随访时间为12个月。腹腔镜组的平均手术时间明显大于开放组,分别为90分钟和70分钟。估计失血量(84 mL vs 156 mL)和住院时间(1天vs 2天)在腹腔镜组明显少于开放组。人口学资料、其他围手术期资料、生活质量评价、主观、客观治愈率、并发症及再手术率均无统计学意义。综上所述,腹腔镜和开放式骶骨阴道固定术具有相当的临床效果。虽然腹腔镜骶骨阴道固定术需要较长的手术时间,但住院时间和出血量明显减少。术后总体生活质量和性生活质量均有明显改善。主观治愈率90%,客观治愈率100%(无任何隔室脱垂)。由于严重的术中并发症,如膀胱或直肠损伤,建议经验丰富的腹腔镜外科医生进行该手术。
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Comparative study between abdominal versus laparoscopic sacral colpopexy

This study was undertaken to compare laparoscopic and open sacral colpopexies for efficacy and safety. This prospective randomized controlled study was conducted in the Gynecologic Department of El-Shatby Maternity Hospital, University of Alexandria in Egypt. It involved 30 women selected after fulfilling the criteria of inclusion into the study with informed consent to participate in the study. All patients in this study were randomly allocated into one of the two following groups: Group A (15 patients) where laparoscopic sacrocolpopexy was done. Group B (15 patients) where abdominal (open) sacrocolpopexy was done. Demographic and hospital data, complications, and follow-up visits were reviewed. Median follow-up was 12 months in the laparoscopic and open groups. Mean operating time was significantly greater in the laparoscopic versus open group, 90 min and 70 min, respectively. Estimated blood loss (84 mL vs 156 mL) and hospital stay duration (1 vs 2 days) were significantly less in the laparoscopic group than the open group. Demographic data, other perioperative data, quality of life assessment, subjective, objective cure rates, complications and reoperation rates were non-significant. As a conclusion, laparoscopic and open sacral colpopexies have comparable clinical outcomes. Although laparoscopic sacral colpopexy requires longer operating time, hospital stay and blood loss are significantly decreased. Postoperatively overall quality of life and sexual quality showed significant improvement. The subjective cure rate was 90%, the objective cure rate (no prolapse in any compartment) was 100%. The procedure is recommended for experienced laparoscopic surgeons because of severe intraoperative complications like bladder or rectal injuries.

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来源期刊
Progresos en Obstetricia y Ginecologia
Progresos en Obstetricia y Ginecologia Medicine-Obstetrics and Gynecology
CiteScore
0.40
自引率
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期刊介绍: Es la Revista Oficial de la Sociedad Española de Ginecología y Obstetricia, y está presente en los más prestigiosos índices de referencia en medicina. Sus contenidos, clasificados en función de 4 grandes áreas (reproducción y endocrinología, perinatología, oncología y ginecología general) resultan de máxima utilidad para el especialista.
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