[使用orihime®补片经阴道补片手术与腹腔镜骶colpop固定术在术后1年的效果比较-在pop评分≤3期的患者中,tvm与LSC相比具有较好的术后病程]。

Kenji Kuroda, Koetsu Hamamoto, Kazuki Kawamura, Akio Horiguchi, Keiichi Ito
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引用次数: 0

摘要

(导言)严重盆腔器官脱垂(POP)患者目前正在接受机器人辅助或腹腔镜骶colpopexy (LSC)的治疗。LSC被认为比经阴道补网手术(TVM)更安全、更有效。然而,即使在使用ORIHIME®补片进行TVM治疗的患者中,也会出现良好的术后结果。我们比较了两种方法中使用ORIHIME®补片的患者在术后结果和并发症发生率方面的差异。(材料和方法)回顾性评价95例POP患者。本院LSC治疗41例,TVM治疗54例。我们使用IPSS、OABSS和ICIQ-SF测量手术前后症状的变化,以及1小时垫重测试和并发症发生率。(结果)术后3 ~ 12个月,两组残尿量及IPSS + QOL评分均显著降低。术后3个月,TVM组尿垫试验结果显示明显降低。术后3 ~ 12个月TVM组所有患者及POP评分≤3期患者,术后12个月LSC组所有患者OABSS和ICIQ-SF评分均显著下降。两组患者术后尿失禁、补片暴露率差异无统计学意义。在2期或3期POP患者中,TVM组脱垂复发率与LSC组一样低。(结论)与LSC相比,使用ORIHIME®补片的TVM在术后1年的病程较好。对于评分≤3期POP-Q的患者应优先考虑TVM手术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[COMPARISON BETWEEN THE EFFECT OF TRANSVAGINAL MESH SURGERY USING ORIHIME® MESH AND LAPAROSCOPIC SACROCOLPOPEXY AT 1 YEAR POSTOPERATIVELY -TVM HAS A FAVORABLE POSTOPERATIVE COURSE COMPARED TO LSC IN PATIENTS WITH POP SCORED ≤ STAGE 3].

(Introduction) Patients with severe pelvic organ prolapse (POP) are currently being treated with robot-assisted or laparoscopic sacrocolpopexy (LSC). LSC is recognized as being more secure and more effective than transvaginal mesh surgery (TVM). However, favorable postoperative outcomes occur even in patients treated with TVM using ORIHIME® mesh. We compared the differences in postoperative outcomes and complication rates between patients who underwent either of these two methods using ORIHIME® mesh. (Material and methods) We retrospectively evaluated 95 patients with POP. In our hospital, 41 patients were treated by LSC, whereas 54 were treated by TVM. We measured the changes in symptoms before and after surgery using the IPSS, OABSS, and ICIQ-SF, and 1-h pad weight testing and complication rates. (Result) Between 3 and 12 months following surgery, both groups' residual urine volume and IPSS plus QOL score significantly decreased. The pad test results revealed a significant decrease 3 months after surgery in the TVM group. From 3 to 12 months after surgery in the TVM group for all patients and patients with POP scored ≤ stage 3, and at 12 months after surgery in the LSC group for all patients, OABSS and ICIQ-SF scores declined significantly. There were no statistically significant differences in the rate of urinary incontinence, mesh exposure after surgery between the two groups. The rate of prolapse recurrence in the TVM group was as low as in the LSC group among patients with stage 2 or 3 POP. (Conclusion) TVM using ORIHIME® mesh has a favorable postoperative course compared to LSC at 1 year postoperatively. TVM surgery should be preferentially considered for patients scored ≤ stage 3 POP-Q.

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