自裁网片腹腔镜阴道骶骨固定术联合阴道后壁修补术与传统阴式手术治疗盆腔器官脱垂的效果比较

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Abstract

Objective To compare the efficacy of self-cutting mesh laparoscopic vaginal sacral fixation combined with vaginal posterior wall repair and traditional vaginal surgery in the treatment of pelvic organ prolapse. Methods A total of 112 patients with pelvic organ prolapse admitted to Jiujiang Maternal and Child Health Hospital from September 2019 to June 2021 were retrospectively selected as the research objects, and were divided into observation group (62 cases) and control group (50 cases) according to different surgical methods. The observation group underwent self-cutting mesh laparoscopic vaginal sacral fixation combined with vaginal posterior wall repair. The control group received traditional total vaginal hysterectomy combined with vaginal wall repair. Operation time, length of hospital stay, intraoperative blood loss, postoperative vaginal length, surgical complications and recurrence rate were compared between the two groups to evaluate the surgical efficacy, and POP-Q values of each point one year after surgery were compared to evaluate the improvement of postoperative pelvic floor function of the two groups. Pelvic floor dysfunction questionnaire (PFDI-20) and pelvic organ prolapse/urinary incontinence questionnaire (PISQ-12) scores were performed 6 months after surgery to evaluate the improvement of postoperative quality of life in both groups. Results The operation time in the observation group was longer than that in the control group, with statistical significance (P＜0.05). There was no significant difference in the length of hospital stay between the two groups (P＞0.05). The amount of intraoperative blood loss in the observation group was less than that in the control group, the length of postoperative vagina in the observation group was longer than that in the control group, and the rate of surgical complications and recurrence was lower than that in the control group, with statistical significances (P＜0.05). There was no significant difference in the quantitative values of POP-Q sites Aa, Ba, Ap, Bp 12 months after operation between the two groups (P＞0.05). The quantitative value of POP-Q site C in the observation group was longer than that in the control group, and the difference was statistically significant (P＜0.05). Six months after surgery, the PFDI-20 score of the observation group was lower than that of the control group, and the PISQ-12 score of the observation group was higher than that of the control group, with statistical significance (P＜0.05). Conclusion Compared with traditional total vaginal hysterectomy combined with anterior and posterior vaginal wall repair, self-cutting mesh laparoscopic vaginal sacral fixation combined with posterior vaginal wall repair is more safe and effective in the treatment of pelvic organ prolapse, which is beneficial to the repair of pelvic floor function and the improvement of sexual quality, while reducing the recurrence rate.

Key words： Laparoscope Vagino-sacral fixation Vaginal posterior wall repair Self-cutting mesh

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