腹腔镜在子宫(或阴道)骶前固定术中的临床应用
Clinical Application of Laparoscopic Presacral Fixation in the Uterus or Vagina
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摘要: 目的 探讨腹腔镜下骶前固定术治疗女性盆腔器官脱垂的有效性和安全性.方法 对51例盆腔器官脱垂的女性患者进行骶前固定术,32例行腹腔镜手术,19例行开腹手术,对比疗效并定期随访.结果 51例患者均全部顺利完成手术,腹腔镜组平均手术时间(255.48±18.15)min,术中平均出血(50±8.2)mL,平均住院时间5 d.开腹组平均手术时间(332.36±11.98)min,术中平均出血(96±11.67)mL,平均住院时间7 d.术后盆腔脏器脱垂症状均全部得到纠正,盆底结构基本恢复正常,所有病例均全部治愈,无一例术后病情复发、网片侵蚀、外漏、局部疼痛、异物感等不适,对性生活无明显影响;腹腔镜组平均手术时间及平均出血均低于开腹组,差异有统计学意义(P<0.05).结论 腹腔镜下子宫(或阴道)骶前固定术治疗女性盆腔器官脱垂,具有创伤小、术中视野清晰、出血少、术后恢复快等特点,近期疗效满意,值得临床推广.Abstract: Objective To explore the efficacy and safety of laparoscopic presacral fixation in the treatment of female pelvic organ prolapse. Methods Fifty-one women patients with pelvic organ prolapse were given presacral fixation. Among them,32 cases were by laparoscopic operation,and 19 cases were by laparotomy,the average blood loss and the average operation time of all patients would be observed. Results All 51 patients were successfully completed surgery. In the group of laparoscopic operation, the average operation time was(255.48 + 18.15)min, the average blood loss was(50±8.2) mL, the average hospital stay was 5 days. In the laparotomy group,the average operation time was(332.36±11.98) min,the average blood loss was(96±11.67) mL, the average hospital stay was 7 days. Pelvic organ prolapse symptoms were all corrected, pelvic structure returned to normal,all patients were cured,with no relapse after surgery, mesh erosion, leakage, local pain, foreign body sensation,discomfort,and had no obvious effect on sex life. The average operation time and average blood loss of group of laparoscopic operation were significantly lower than the laparotomy group(P<0.05). Conclusion Presacral fixation of uterine or vagina under laparoscope for the treatment of female pelvic organ prolapsed has such advantages as less trauma, clear surgery vision, less bleeding and quick recovery, satisfactory shor-term effect, and is worthy of promotion.
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Key words:
- Pelvic organ prolapse /
- Presacral fixation /
- Laparoscope /
- Pelvic floor dysfunction
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