Transvaginal Repair of Apical Vesicovaginal Fistula: A Modified Latzko Technique-Outcomes at a High-volume Referral Center
Transvaginal Repair of Apical Vesicovaginal Fistula: A Modified Latzko Technique-Outcomes at a High-volume Referral Center
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DOI：
10.1016/j.eururo.2019.04.010
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发表时间：
2019-07-01
期刊：
影响因子：
23.4
通讯作者：
Shen, Hong
中科院分区：
文献类型：
--
作者：
Luo, De-Yi;Shen, Hong
背景：膀胱阴道瘘（VVF）是一种令女性痛苦的疾病。经阴道 VVF 修复方法通常是首选，因为与腹部方法相比，其微创性质似乎具有多种优势，包括减少疼痛和失血以及减少住院时间。 VVF 修复手术中常用的技术是 Latzko 技术，由于妇科手术后留下了坚硬的横向疤痕，该技术对于位于阴道顶端的瘘管可能会很困难。 目的：展示替代改良经阴道修复技术治疗顶端膀胱阴道瘘的有效性和安全性。 设计、设置和参与者：在一家大容量医院进行了一项回顾性队列研究。 2009 年至 2016 年间，共有 108 名既往诊断为心尖 VVF 的女性患者接受了瘘管修复术。我们联系了这些患者，并对她们进行了随访检查。手术过程：进行了改良的 Latzko 技术进行心尖 VVF 修复。测量：进行了图表审查。结果和局限性：患者的平均年龄为 47 (22-77) 岁。平均随访时间为 40.7 (12-84) 个月。 VVF 在所有程序中均已关闭。没有立即或延迟的并发症。所有患者在术后患者总体印象改善问卷中得分较高。结论：我们的研究表明，采用改良 Latzko 技术进行经阴道根尖 VVF 修复术是可行且有效的，并且效果持久，无明显并发症。患者总结：我们研究了一种治疗根尖膀胱阴道瘘的替代手术技术。我们的结论是，该技术简单、安全、有效，没有明显的并发症。 (C) 2019 年欧洲泌尿外科协会。由 Elsevier B.V. 出版。保留所有权利。
Background: Vesicovaginal fistula (VVF) is a distressing disorder in women. The transvaginal method of VVF repair is generally preferred, as its minimally invasive nature appears to offer several advantages compared with the abdominal approach, including decreased pain and blood loss and reduced hospital stay. A common technique used in VVF repair surgery is the Latzko technique, which may be difficult for the fistula located at the vaginal apex, due to the firm transverse scar left after the inciting gynecological surgery.Objective: To show the efficacy and safety of an alternative modified transvaginal repair technique for apical vesciovaginal fistula.Design, setting, and participants: A retrospective cohort study was conducted at a high-volume hospital. A total of 108 female patients, previously diagnosed with apical VVF, underwent fistula repair between 2009 and 2016. Those patients were contacted, and they underwent a follow-up examination.Surgical procedure: The modified Latzko technique for apical VVF repair was performed.Measurements: A chart review was performed.Results and limitations: The mean age of the patients was 47 (22-77) yr. The average follow-up time was 40.7 (12-84) mo. The VVF was closed in all procedures. There was no immediate or delayed complication. All patients scored higher in the Patient Global Impression of Improvement questionnaire after the surgery.Conclusions: Our study indicates that the transvaginal repair of apical VVF with a modified Latzko technique is feasible and effective, and offers durable results without apparent complications.Patient summary: We studied an alternative surgical technique for the treatment of apical vesicovaginal fistula. We conclude that this technique is simple, safe, and effective, with no apparent complications. (C) 2019 European Association of Urology. Published by Elsevier B.V. All rights reserved.