[1]施素华** 周毅惠 丁华峰 倪观太 周伟.腹腔镜下髂耻韧带固定术治疗盆腔脏器脱垂[J].中国微创外科杂志,2019,01(1):34-38.
　Shi Suhua,Zhou Yihui,Ding Huafeng,et al.Laparoscopic Pectopexy in the Treatment of Pelvic Organ Prolapse[J].Chinese Journal of Minimally Invasive Surgery,2019,01(1):34-38.
点击复制

腹腔镜下髂耻韧带固定术治疗盆腔脏器脱垂()
分享到：

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2019年1期
页码:
34-38
栏目:
临床研究
出版日期:
2019-01-25

文章信息/Info

Title:
Laparoscopic Pectopexy in the Treatment of Pelvic Organ Prolapse
作者:
施素华** 周毅惠 丁华峰 倪观太 周伟
（皖南医学院第一附属医院妇产科，芜湖241001）
Author(s):
Shi Suhua;  Zhou Yihui;  Ding Huafeng;  et al.
Department of Obstetrics and Gynecology, First Affiliated Hospital of Wannan Medical College, Wuhu 241001, China
关键词:
腹腔镜; 髂耻韧带固定术; 盆腔脏器脱垂
Keywords:
Laparoscopy; Pectopexy; Pelvic organ prolapse
文献标志码:
A
摘要:
目的探讨腹腔镜下髂耻韧带固定术治疗盆腔器官脱垂（pelvic organ prolapse，POP）的临床疗效。方法2014年11月～2017年9月我院妇科对40例POPQ分期≥Ⅱ期、以中盆腔脱垂为主的POP行腹腔镜下髂耻韧带固定术。采用POPQ分期法、盆底功能障碍问卷-20(PFDI20) 、盆底疾病生活质量影响问卷短表-7( PFIQ7) 、盆腔器官脱垂/尿失禁性生活质量问卷-12( PISQ12) 问卷调查评价解剖和功能疗效。结果40例均成功完成手术，术中未出现肠管、输尿管、膀胱、血管及神经损伤。术后1～2 d拔除尿管均能自主排尿，无尿潴留。术后随访(20.3±6.2)月，未发现网片侵蚀、暴露等并发症。术后3个月POPQ分期法测定均无脱垂，解剖治愈率100%。2例分别在术后12、18个月出现阴道前壁脱垂。PFIQ7评分术前(67.7±1.8)分，明显高于术后末次随访(12.2±1.4)分(t=172.807,P=0.000）；PFDI20评分术前（60.5±3.1）分，明显高于术后（11.7±1.1）分（t=94586,P=0.000）；PSIQ12评分由术前（61.2 ±9.3）分提高为术后末次随访（70.0±8.3）分（t=-5.588,P=0.000）。术后患者主观满意度92.5%（37/40）。结论腹腔镜下髂耻韧带固定术是治疗以子宫脱垂为主的POP微创、简单、安全、有效的方法。
Abstract:
ObjectiveTo evaluate the clinical effectiveness of laparoscopic pectopexy for pelvic organ prolapse (POP). MethodsFrom November 2014 to September 2016, 40 patients with POP (POPQ≥Ⅱ) underwent laparoscopic pectopexy in our hospital. The pelvic organ prolapse quantification (POPQ) scores, pelvic floor impact questionnaireshort form 7 (PFIQ7), pelvic floor distress inventory short form 20 (PFDI20), and POP/urinary incontinence sexual questionnaire 12 (PISQ12) were undertaken to evaluated the anatomic and functional recovery of surgery.ResultsThe operations were successfully completed in the 40 patients. No injuries of rectum, urethra, bladder, great vessels and nerves occurred. After the operation, the catheter was retained for 1-2 days, and all of the patients were able to micturate after extubation. The followup time was (20.3±6.2) months. No mesh erosion or exposure occurred. According to the POPQ, all the cases were cured without recurrence within 3 months of followup. The anatomic cure rate of the surgery was 100%. Anterior defect cystocele relapsed in two patients at 12 and 18 months postoperatively. The scores of PFIQ7 were recovered from (67.7±1.9) points preoperatively to (12.2±1.4) points postoperatively (t=172.807, P=0.000). The PFDI20 scores were recovered from (60.5±3.1) points to (11.7±1.1) points (t=94.586, P=0.000). The PISQ12 scores increased from (61.2±9.3) points to (70.0±8.3) points (t=-5.588, P=0.000). The postoperative satisfaction rate was 925% (37/40).ConclusionLaparoscopic pectopexy offers a microinvasive, safe, and effective alternative for POP.

参考文献/References:

[1]Luber KM, Boero S, Choe JY. The demographics of pelvic floor disorders: current observations and future projections. Am J Obstet Gynecol,2001,184(7):1496-1503.
[2]Banerjee C, Noé KG. Laparoscopic pectopexy: a new technique of prolapse surgery for obese patients.Arch Gynecol Obstet,2011,284(3):631-635.
[3]Handa VL, Garrett ES, Gold E, et al. Progression and remission of pelvic organ prolapse: a longitudinal study of menopausal women. Am J Obstet Gynecol,2004,190(1):27-32.
[4]Barber MD, Walters M D, Bump RC. Short forms of two conditionspecific qualityoflife questionnaires for women with pelvic floor disorders (PFDI20 and PFIQ7). Am J Obstet Gynecol,2005,193(1):103-113.
[5]Rogers RG, Coates KW, KammererDoak D, et al. A short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ12). Int Urogynecol J Pelvic Floor Dysfunct,2003,14(3):164-168.
[6]Kenton K,Mueller ER. The global burden of female pelvic floor disorders. BJU Int,2006,98(Suppl 1):1-7．
[7]Pilka R, Gágyor D, tudentová M, et al. Laparoscopic and robotic sacropexy: retrospective review of learning curve experiences and followup. Ceska Gynekol,2017,82(4):261-267.
[8]Kale A, Biler A, Terzi H, et al. Laparoscopic pectopexy: initial experience of single center with a new technique for apical prolapse surgery. Int Braz J Urol,2017,43(5):903-909.
[9]Faure JP, Hauet T, Scepi M, et al. The pectineal ligament: anatomical study and surgical applications. Surg Radiol Anat,2001,23(4):237-242.
[10]Burch JC. Urethrovaginal fixation to Cooper’s ligament for correction of stress incontinence, cystocele, and prolapse. Am J Obstet Gynecol,1961,81(81):281-290.
[11]梁志清,徐惠成,陈勇,等.张力性尿失禁腹腔镜Burch氏膀胱颈悬吊术治疗.重庆医学,2002,31(7):577-578.
[12]Cosson M, Boukerrou M, Lacaze S, et al. A study of pelvic ligament strength. Eur J Obstet Gynecol Reprod Biol,2003,109(1):80-87.
[13]Noé KG, Spüntrup C, Anapolski M. Laparoscopic pectopexy: a randomised comparative clinical trial of standard laparoscopic sacral colpocervicopexy to the new laparoscopic pectopexy. Shortterm postoperative results.Arch Gynecol Obstet,2013,287(2):275-280.
[14]Noé KG, Schiermeier S, Alkatout I, et al. Laparoscopic pectopexy: a prospective, randomized, comparative clinical trial of standard laparoscopic sacral colpocervicopexy with the new laparoscopic pectopexypostoperative results and intermediateterm followup in a pilot study. J Endourol,2015,29(2):210-215.
[15]Sauerwald A, Niggl M, Puppe J, et al. Laparoscopic pectopexy: a biomechanical analysis. PLoS One,2016,11(2):e0144143.
[16]Tahaoglu AE, Bakir MS, Peker N, et al. Modified laparoscopic pectopexy: shortterm followup and its effects on sexual function and quality of life. Int Urogynecol J,2018,29(8):1155-1160.

备注/Memo

备注/Memo:
基金项目：安徽省卫生计生委科研计划项目（2016QK046）**通讯作者，Email：13965190237@139.com
更新日期/Last Update: 2019-04-09