[1]陈莉侯涛**何珊钟绮君.经阴道自然腔道内镜下高位骶韧带悬吊术联合自体组织修复治疗盆腔器官脱垂和远期疗效[J].中国微创外科杂志,2026,01(6):335-341.
　Chen Li,Hou Tao,He Shan,et al.Transvaginal Natural Orifice Transluminal Endoscopic Surgeryhigh Uterosacral Ligament Suspension Combined With Native Tissue Repair for Pelvic Organ Prolapse and Longterm Efficacy[J].Chinese Journal of Minimally Invasive Surgery,2026,01(6):335-341.
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经阴道自然腔道内镜下高位骶韧带悬吊术联合自体组织修复治疗盆腔器官脱垂和远期疗效()

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

卷:
01
期数:
2026年6期
页码:
335-341
栏目:
临床论著
出版日期:
2026-06-22

文章信息/Info

Title:
Transvaginal Natural Orifice Transluminal Endoscopic Surgeryhigh Uterosacral Ligament Suspension Combined With Native Tissue Repair for Pelvic Organ Prolapse and Longterm Efficacy
作者:
陈莉侯涛**何珊钟绮君
(梅州市人民医院妇一科，梅州514000)
Author(s):
Chen Li;  Hou Tao;  He Shan;  et al.
Department of Gynecology, Meizhou People’s Hospital, Meizhou 514000, China
关键词:
经阴道自然腔道内镜手术; 高位骶韧带悬吊术; 盆腔器官脱垂
Keywords:
Transvaginal natural orifice transluminal endoscopic surgery; High uterosacral ligament suspension; Pelvic organ prolapse
文献标志码:
A
摘要:
目的探讨经阴道自然腔道内镜下高位骶韧带悬吊术(transvaginal natural orifice transluminal endoscopic surgeryhigh uterosacral ligament suspension，vNOTESHUS)治疗盆腔器官脱垂定量 (pelvic organ prolapse quantification，POPQ) Ⅱ度以上患者的远期疗效。方法2018年12月~2022年7月我科53例盆腔器官脱垂（pelvic organ prolapse，POP）行阴式子宫切除+vNOTESHUS并完成3年以上随访，同时行阴道前壁修补术34例，阴道后壁修补术9例，阴道紧缩术10例等。通过POPQ分度、盆底功能障碍问卷调查表(Pelvic Floor Distress Inventoryshort Form 20，PFDI20)、患者整体印象改善(Patient Global Impression of Improvement，PGII)评分和复发情况评估手术后疗效及主观满意度。结果53例顺利完成手术，手术时间80（65，100） min，术中出血量30（20，30）ml。围手术期并发症ClavienDindo Ⅰ级3例，Ⅱ级2例，Ⅲ级1例。53例随访时间53(47，75)个月。末次随访POPQ分度阴道前壁(Z=-5.968，P=0.000)、阴道顶端(Z=-6.527，P=0.000)及阴道后壁(Z=-3.507，P=0.000)较术前明显改善。手术成功率925%（49/53）。术前后各时点POPQ各指示点Aa、Ba、C、PFDI20比较差异均有显著性(P<005)，Ap、Bp除术后即时与术后1年差异无显著性(P=0.157，0.564)外，其他各时点比较差异均有显著性(P<0.05)。PGII评分1、2分49例，总体主观满意率92.5%(49/53)，4例不满意者主要是阴道前壁复发，阴道前壁复发率75%(4/53)，阴道顶端、后壁无复发。结论vNOTESHUS治疗POP长期疗效好，解剖成功率高，可提高患者的主观满意度。
Abstract:
ObjectiveTo evaluate the longterm efficacy of transvaginal natural orifice transluminal endoscopic surgeryhigh uterosacral ligament suspension (vNOTESHUS) in the treatment of patients with pelvic organ prolapse quantification (POPQ) stage Ⅱ or above.MethodsFrom December 2018 to July 2022, 53 patients underwent vaginal hysterectomy combined with vNOTESHUS for pelvic organ prolapse (POP) and completed at least 3 years of followup. Among them, 34 underwent concurrent anterior vaginal wall repair, 9 underwent posterior vaginal wall repair, and 10 underwent vaginal tightening. Surgical outcomes and patient subjective satisfaction were evaluated by using POPQ staging, the Pelvic Floor Distress InventoryShort Form 20 (PFDI20), the Patient Global Impression of Improvement (PGII), and recurrence assessment.ResultsAll the 53 patients successfully underwent the surgery. The median operative time was 80 (65, 100) min, and the intraoperative blood loss was 30 (20, 30) ml. Perioperative complications included 3 cases of ClavienDindo grade Ⅰ, 2 cases of grade Ⅱ, and 1 case of grade Ⅲ. The median followup duration was 53 (47, 75) months. At the last followup, the POPQ stages of the anterior vaginal wall (Z=-5.968, P=0.000), vaginal apex (Z=-6.527, P=0.000), and posterior vaginal wall (Z=-3.507, P=0.000) were significantly improved compared with preoperative values. The success rate of surgery was 92.5%(49/53). Comparisons of POPQ indicator points before and after surgery showed that Aa, Ba, C, and the PFDI20 score demonstrated significant differences at all time points compared with preoperative values (P<0.05). For Ap and Bp, significant differences were observed at all time points (P<0.05), except between immediate postoperative and 1 year postoperative (P=0157, 0564). Regarding the PGII scale, 49 patients scored 1 or 2 points, yielding an overall subjective satisfaction rate of 92.5%(49/53). Among the 4 dissatisfied patients, the main reason was recurrence of the anterior vaginal wall, with a recurrence rate of 75%(4/53). No recurrences were observed at the vaginal apex or the posterior vaginal wall.ConclusionvNOTESHUS is an effective treatment for POP, demonstrating favorable longterm outcomes, high anatomical success rates, and improved patient subjective satisfaction.

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备注/Memo

备注/Memo:
基金项目：梅州市人民医院科研培育项目（PY-C2022053）**通讯作者，Email：GDhoutao@126.com
更新日期/Last Update: 2026-06-22