Laparoscopic sacral colpopey approach for genito-urinary prolapse: Experience with 363 cases
Laparoscopic sacral colpopey approach for genito-urinary prolapse: Experience with 363 cases
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DOI：
10.1016/j.eururo.2004.08.014
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发表时间：
2005-02-01
期刊：
影响因子：
23.4
通讯作者：
Vallancien, G
中科院分区：
文献类型：
--
作者：
Rozet, F;Mandron, E;Vallancien, G
目的：为了评估手术结果，并发症和腹腔镜双promonto固定盆腔prolapse.Methods患者的好处：女性生殖泌尿系统脱垂进行了经腹膜放置的100%聚酯网的阴道前壁和肛提肌后网。这两个都被固定在骶骨岬上。TVT同时放置在并发压力性尿失禁的患者中。结果：在1996年至2002年期间，共有363例患者进行了手术。他们的平均年龄为63岁（范围35-78），平均随访时间为14.6个月，平均手术时间为97分钟。有8例因麻醉或手术困难而转换。随访通过邮寄问卷和6个月时的体格检查完成，然后每年进行一次。96%的患者对手术效果满意，无患者主诉性功能障碍。脱垂复发率为4%，3例阴道糜烂，2例尿潴留，需要TVT部分，1例肠嵌顿，1例脊柱炎和2例网infection.Conclusions：腹腔镜promonto固定是可行的，高效的技术，提供了良好的长期结果，并发症发生率类似于开放手术，微创手术的额外好处。(C)2004 Elsevier B. V.保留所有权利。
Objective: To evaluate the surgical outcome, complications and benefits of laparoscopic double promonto-fixation for patients with pelvic prolapse.Methods: Women with genito-urinary prolapse underwent a transperitoneal placement of a 100% polyester mesh on the anterior vaginal wall and a posterior mesh on the levator ani muscle. Both of these were anchored to the sacral promontory. A TVT was placed simultaneously in patients who had concurrent stress urinary incontinence.Results: A total of 363 patients were operated upon between 1996 and 2002. Their mean age was 63 (range 35-78), average follow-up was 14.6 months, the mean operating time was 97 minutes. There were 8 conversions due to anesthetic or surgical difficulties. Follow up was done by a postal questionnaire and physical examination at 6 months and then yearly. 96% were satisfied with the results of their operation and no patients complained of sexual dysfunction. There was a 4% recurrence rate of prolapse, 3 vaginal erosions, 2 urinary retentions that required TVT section, 1 bowel incarcerations, 1 spondylitis and 2 mesh infection.Conclusions: Laparoscopic promonto-fixation is feasible and highly effective technique that offers good long-term results with complication rates similar to open surgery, with the added benefits of minimally invasive surgery. (C) 2004 Elsevier B.V. All rights reserved.