人工植入物在生殖脱垂手术中的有效性

I. M. Ordiyants, I. A. Aleev, E.G. Ordiyants, D. R. Asatryan
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摘要

本研究的目的是评估在不同年龄层的女性进行生殖脱垂手术的合成植入物的有效性。材料与方法:139例患者行阴道脱垂手术,人工合成补片和生物移植。对于阴道壁的前后和完全重建,使用了两种网状植入物:Pelvix (Lintex,俄罗斯)和proflift (Ethicon Women’s Health and Urology, Johnson and Johnson Company, USA)。网状种植体的大小根据具体情况进行调整。结果。术中最常见的并发症是术中失血。在盆底重建中,网状植入物在育龄期和围绝经期分别是移植物的1.8倍和1.5倍。在绝经后,在生物移植手术中有更大的失血趋势。在育龄期,补片修复和非补片修复的早期术后并发症发生率相同。在围绝经期,并发症是网状修复的三倍,而在绝经后,无论使用何种修复,每三名接受检查的患者中就有一名出现并发症。生物移植术后后期并发症(盆腔疼痛和性交困难)的发生率更高:育龄期为2次,围绝经期为1.5次,绝经后为补片的5倍。结论。脱垂手术与合成假体是有效的,安全的和合理的发病机制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
EFFECTIVENESS OF SYNTHETIC IMPLANTS FOR GENITAL PROLAPSE SURGERY
The aim of the study is to evaluate the effectiveness of synthetic implants for genital prolapse surgery in women of different age groups. Materials and Methods. 139 patients underwent genital prolapse surgery, vaginal approach, with synthetic mesh and biologic grafts. For the anterior, posterior and complete reconstruction of the vaginal walls, two mesh implants were used: Pelvix (Lintex, Russia) and Prolift (Ethicon Women´s Health and Urology, Johnson and Johnson Company, USA). The size of mesh implant was adapted to each particular case. Results. The most common intraoperative complication was intraoperative blood loss. During pelvic floor reconstruction with mesh implants, it was 1.8 times and 1.5 times higher in reproductive age and perimenopause respectively, compared with grafts. In postmenopause, there was a tendency to greater blood loss in surgeries with biological grafts. In reproductive age, the frequency of early postoperative complications was the same for mesh and non-mesh repair. In perimenopause, complications were three times more often for mesh repair, and in postmenopause, complications were observed in every third examined patient, regardless of the repair used. Late postoperative complications (pelvic pain and dyspareunia) occurred more often for biological graft: in reproductive age – twice, in perimenopause – 1.5 times, and in postmenopause – 5 times as frequently as for mesh. Conclusion. Prolapse surgery with synthetic implants is effective, safe and justified in terms of pathogenesis.
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