{"title":"腹腔镜下外侧悬吊与高位子宫骶韧带悬吊治疗根尖脱垂的回顾性临床研究。","authors":"Y Yu, L Mei, Y Chen, T Cui, D Wei, X Niu","doi":"10.1007/s10151-025-03124-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The aim of this retrospective clinical study is to assess clinical outcomes and patient satisfaction between laparoscopic lateral suspension (LLS) with mesh and laparoscopic high uterosacral ligament suspension (LHUS) for apical prolapse with or without anterior prolapse.</p><p><strong>Methods: </strong>Patients who underwent LLS with mesh or LHUS from 2019 to 2023 at the Second West China Hospital of Sichuan University were enrolled in this retrospective study. The objective outcomes were evaluated on the basis of the anatomical success rate according to the Pelvic Organ Prolapse Quantification System (POP-Q). The subjective outcomes were assessed using the Pelvic Floor Distress Inventory (PFDI-20) questionnaire, Pelvic Floor Impact Questionnaire (PFIQ-7), Patient Global Impression of Improvement (PGI-I) scores, and complications rate. Complications were defined according to the Clavien-Dindo scale. The outcomes of the postoperative 3, 6, and 12 months were analyzed retrospectively.</p><p><strong>Results: </strong>The objective and subjective outcomes indicated improvements in both groups. There was no statistically significant difference between the two groups in the change of subjective outcomes. The short-term objective and subjective outcomes for both techniques were found to be comparable. The anatomical success rate for apical and anterior prolapse was 93.85% in the LHUS group and 93.44% in the LLS group at a median follow-up of 12 months. LLS demonstrated a superior effect on the degree of postoperative point Ba (the distance from the most protruding point to the hymen on the anterior vaginal wall) improvement compared with LHUS.</p><p><strong>Conclusions: </strong>LHUS and LLS are both effective, safe surgical techniques for the treatment of apical prolapse, with or without concomitant anterior prolapse, exhibiting low complication rates and high short-term anatomical cure rates. LLS demonstrated certain advantages over LHUS in terms of anterior prolapse improvement and symptom relief.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"84"},"PeriodicalIF":2.9000,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933215/pdf/","citationCount":"0","resultStr":"{\"title\":\"Comparison of laparoscopic lateral suspension and high uterosacral ligament suspension for apical prolapse: a retrospective clinical study.\",\"authors\":\"Y Yu, L Mei, Y Chen, T Cui, D Wei, X Niu\",\"doi\":\"10.1007/s10151-025-03124-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The aim of this retrospective clinical study is to assess clinical outcomes and patient satisfaction between laparoscopic lateral suspension (LLS) with mesh and laparoscopic high uterosacral ligament suspension (LHUS) for apical prolapse with or without anterior prolapse.</p><p><strong>Methods: </strong>Patients who underwent LLS with mesh or LHUS from 2019 to 2023 at the Second West China Hospital of Sichuan University were enrolled in this retrospective study. The objective outcomes were evaluated on the basis of the anatomical success rate according to the Pelvic Organ Prolapse Quantification System (POP-Q). The subjective outcomes were assessed using the Pelvic Floor Distress Inventory (PFDI-20) questionnaire, Pelvic Floor Impact Questionnaire (PFIQ-7), Patient Global Impression of Improvement (PGI-I) scores, and complications rate. Complications were defined according to the Clavien-Dindo scale. The outcomes of the postoperative 3, 6, and 12 months were analyzed retrospectively.</p><p><strong>Results: </strong>The objective and subjective outcomes indicated improvements in both groups. There was no statistically significant difference between the two groups in the change of subjective outcomes. The short-term objective and subjective outcomes for both techniques were found to be comparable. The anatomical success rate for apical and anterior prolapse was 93.85% in the LHUS group and 93.44% in the LLS group at a median follow-up of 12 months. LLS demonstrated a superior effect on the degree of postoperative point Ba (the distance from the most protruding point to the hymen on the anterior vaginal wall) improvement compared with LHUS.</p><p><strong>Conclusions: </strong>LHUS and LLS are both effective, safe surgical techniques for the treatment of apical prolapse, with or without concomitant anterior prolapse, exhibiting low complication rates and high short-term anatomical cure rates. LLS demonstrated certain advantages over LHUS in terms of anterior prolapse improvement and symptom relief.</p>\",\"PeriodicalId\":51192,\"journal\":{\"name\":\"Techniques in Coloproctology\",\"volume\":\"29 1\",\"pages\":\"84\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2025-03-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933215/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Techniques in Coloproctology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10151-025-03124-4\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Techniques in Coloproctology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10151-025-03124-4","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Comparison of laparoscopic lateral suspension and high uterosacral ligament suspension for apical prolapse: a retrospective clinical study.
Background: The aim of this retrospective clinical study is to assess clinical outcomes and patient satisfaction between laparoscopic lateral suspension (LLS) with mesh and laparoscopic high uterosacral ligament suspension (LHUS) for apical prolapse with or without anterior prolapse.
Methods: Patients who underwent LLS with mesh or LHUS from 2019 to 2023 at the Second West China Hospital of Sichuan University were enrolled in this retrospective study. The objective outcomes were evaluated on the basis of the anatomical success rate according to the Pelvic Organ Prolapse Quantification System (POP-Q). The subjective outcomes were assessed using the Pelvic Floor Distress Inventory (PFDI-20) questionnaire, Pelvic Floor Impact Questionnaire (PFIQ-7), Patient Global Impression of Improvement (PGI-I) scores, and complications rate. Complications were defined according to the Clavien-Dindo scale. The outcomes of the postoperative 3, 6, and 12 months were analyzed retrospectively.
Results: The objective and subjective outcomes indicated improvements in both groups. There was no statistically significant difference between the two groups in the change of subjective outcomes. The short-term objective and subjective outcomes for both techniques were found to be comparable. The anatomical success rate for apical and anterior prolapse was 93.85% in the LHUS group and 93.44% in the LLS group at a median follow-up of 12 months. LLS demonstrated a superior effect on the degree of postoperative point Ba (the distance from the most protruding point to the hymen on the anterior vaginal wall) improvement compared with LHUS.
Conclusions: LHUS and LLS are both effective, safe surgical techniques for the treatment of apical prolapse, with or without concomitant anterior prolapse, exhibiting low complication rates and high short-term anatomical cure rates. LLS demonstrated certain advantages over LHUS in terms of anterior prolapse improvement and symptom relief.
期刊介绍：
Techniques in Coloproctology is an international journal fully devoted to diagnostic and operative procedures carried out in the management of colorectal diseases. Imaging, clinical physiology, laparoscopy, open abdominal surgery and proctoperineology are the main topics covered by the journal. Reviews, original articles, technical notes and short communications with many detailed illustrations render this publication indispensable for coloproctologists and related specialists. Both surgeons and gastroenterologists are represented on the distinguished Editorial Board, together with pathologists, radiologists and basic scientists from all over the world. The journal is strongly recommended to those who wish to be updated on recent developments in the field, and improve the standards of their work.
Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1965 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the Principles of Laboratory Animal Care (NIH publication no. 86-23 revised 1985) were followed as were applicable national laws (e.g. the current version of the German Law on the Protection of Animals). The Editor-in-Chief reserves the right to reject manuscripts that do not comply with the above-mentioned requirements. Authors will be held responsible for false statements or for failure to fulfill such requirements.
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