[1]严维高 卞爱平 树娟① 曹春美 蔡培菊 郝昆林**.经脐单孔腹腔镜高位骶韧带悬吊、髂耻韧带固定治疗中盆腔缺陷为主的盆腔器官脱垂[J].中国微创外科杂志,2024,01(7):494-497.
　Yan Weigao*,Bian Aiping*,Shu Juan,et al.Transumbilical Singleport Laparoscopic High Uterosacral Ligament Suspension and Iliacpubic Ligament Fixation for Pelvic Organ Prolapse Mainly Caused by Middle Pelvic Defects[J].Chinese Journal of Minimally Invasive Surgery,2024,01(7):494-497.
点击复制

经脐单孔腹腔镜高位骶韧带悬吊、髂耻韧带固定治疗中盆腔缺陷为主的盆腔器官脱垂()
分享到：

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

卷:
01
期数:
2024年7期
页码:
494-497
栏目:
短篇论著
出版日期:
2024-08-25

文章信息/Info

Title:
Transumbilical Singleport Laparoscopic High Uterosacral Ligament Suspension and Iliacpubic Ligament Fixation for Pelvic Organ Prolapse Mainly Caused by Middle Pelvic Defects
作者:
严维高 卞爱平 树娟① 曹春美 蔡培菊 郝昆林**
(南通大学附属泰州妇产医院妇科，泰州225300)
Author(s):
Yan Weigao*;  Bian Aiping*;  Shu Juan;  et al.
*Department of Gynecology, Taizhou Maternity Hospital Affiliated to Nantong University, Taizhou 225300, China
关键词:
中盆腔缺陷; 经脐单孔腹腔镜手术; 高位骶韧带悬吊
Keywords:
Middle pelvic cavity defect; Transumbilical singlesite laparoscopic surgery; High uterosacral ligament suspension
文献标志码:
A
摘要:
目的探讨经脐单孔腹腔镜高位骶韧带悬吊、髂耻韧带固定治疗中盆腔缺陷为主的盆腔器官脱垂的疗效。方法回顾性分析2017年6月~2023年6月中盆腔缺陷为主的盆腔器官脱垂15例资料，行经脐单孔腹腔镜高位骶韧带悬吊、髂耻韧带固定术。术后1年采用妇科检查(POPQ系统)及应力状态盆腔MRI检查进行客观评估；采用盆底不适调查表简表(Pelvic Floor Distress Inventory Short Form，PFDI20)、盆腔器官脱垂及尿失禁性生活问卷(Pelvic Organ ProlapseUrinary Incontinence Sexual Questionnaire，PISQ12)进行主观评估。结果手术时间65~135 min，(102.9±16.3)min，出血20~50 ml，术后住院时间6~9 d。随访时间6~72个月，(42.8±22.3)月，其中14例≥12个月，均未出现盆腔疼痛、腰骶部疼痛、尿潴留、线带暴露。1例术后1年出现压力性尿失禁(stress urinary incontinence，SUI)。1例失败(Ⅱ度)，客观成功率93.3%(14/15)。术后1年盆腔MRI解剖标志点至耻尾线的距离较术前明显提高(P<0.01)，PFDI20、PISQ12评分较术前明显改善(P<0.01)。结论经脐单孔腹腔镜高位骶韧带悬吊、髂耻韧带固定是治疗有手术指征的中盆腔缺陷为主的盆腔器官脱垂安全、有效的互助术式，改善盆底功能和生活质量，简单易掌握，且耗材费用低，适合基层医院开展。
Abstract:
ObjectiveTo explore the therapeutic effect of transumbilical singleport laparoscopic high uterosacral ligament suspension (HUS) and iliacpubic ligament fixation (ILF) in the treatment of pelvic organ prolapse (POP) mainly caused by middle pelvic defects.MethodsClinical data of 15 cases of POP with middle pelvic defects from June 2017 to June 2023 were analyzed retrospectively. The HUS and ILF were performed by transumbilical singleport laparoscopy. At one year after operation, gynecological examination (POPQ system) and maximum straining pelvic MRI examination were performed for objective evaluation. The Pelvic Floor Distress Inventory Short Form (PFDI20) and Pelvic Organ ProlapseUrinary Incontinence Sexual Questionnaire (PISQ12) were used for subjective evaluation.ResultsThe operation time was 65-135 min (mean, 102.9±16.3 min), the bleeding volume was 20-50 ml, and the postoperative hospital stay was 6-9 d. Followup time ranged from 6 to 72 months (mean, 42.8±22.3 months), among which 14 cases were ≥ 12 months. No pelvic pain, lumbosacral pain, urinary retention and thread exposure occurred. Stress urinary incontinence (SUI) occurred in 1 case at 1 year after operation. Surgical failure was noted in 1 case (degree Ⅱ), the objective success rate being 93.3% (14/15). At 1 year after operation, the distance from the anatomical landmarks of pelvic MRI to the pubococcygeal line (PCL) was significantly higher than that before operation (P<0.01), and the PFDI20 and PISQ12 scores were significantly better than those before operation (P<0.01).ConclusionsTransumbilical singleport laparoscopic HUS and ILF is a safe and effective mutual aid procedure for the treatment of POP mainly caused by middle pelvic defects with surgical indications, which can improve pelvic floor function and quality of life. It is simple and easy to perform with low cost of consumables, which is suitable for primary hospitals.

参考文献/References:

[1]乔杰,马丁,主编.妇产科学.第3版.北京:人民卫生出版社,2023.504-509.
[2]朱兰,郎景和,主编.女性盆底学.第3版.北京:人民卫生出版社,2021.33-34.
[3]El Sayed RF,Alt CD,Maccioni F,et al;ESUR and ESGAR Pelvic Floor Working Group.Magnetic resonance imaging of pelvic floor dysfunction:joint recommendations of the ESUR and ESGAR Pelvic Floor Working Group.Eur Radiol,2017,27(5):2067-2085.
[4]王建六,廖利民,任东林,主编.盆底医学.第1版.北京:北京大学出版社,2021.698-705,533-600,1341,1204-1205.
[5]徐婉婉,赵小峰.治疗中盆腔缺陷的盆底修复手术方式研究进展.浙江医学杂志,2021,43(6):687-690.
[6]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.
[7]Banerjee C,Noé KG.Laparoscopic pectopexy:a new technique of prolapse surgery for obese patients.Arch Gynecol Obstet,2011,284(3):631-635.
[8]周伟,周毅惠,施素华,等.腹腔镜下髂耻韧带固定术治疗中盆腔器官脱垂的远期疗效分析.现代妇产科进展,2022,31(1):54-57.
[9]严维高,姜涛,王文吉.腹腔镜高位骶韧带悬吊联合传统术式治疗育龄女性盆腔器官脱垂17例分析.中国微创外科杂志，2022,22(9):743-747.
[10]孙之星,朱兰,胡惠英,等.腹腔镜高位宫骶韧带悬吊术联合子宫颈截除术治疗生育期子宫脱垂的长期疗效及性功能评价.中华妇产科杂志,2014,49(3):167-171.

备注/Memo

备注/Memo:
基金项目：泰州市科技支撑计划社会发展指令项目(SSF20210092)**通讯作者，Email：869754897@qq.com ①手术室
更新日期/Last Update: 2024-10-06