腹腔镜骶管固定与阴道骶管固定治疗盆腔器官脱垂：手术结果和生活质量的回顾性比较
Laparoscopic Sacropexy Versus Vaginal Sacrospinous Fixation for Pelvic Organ Prolapse: A Retrospective Comparison of Surgical Outcomes and Quality of Life.
摘要(中文译文)
背景：盆腔器官脱垂（POP）显著影响女性的生活质量。目前存在两种既定的手术方法：腹腔镜骶固定术（LSC）和阴道骶棘固定术（SSLF）。本研究比较了这些技术的手术结果、并发症发生率和生活质量。方法：这项回顾性单中心研究纳入了2020年至2023年间接受治疗的58名患者：41名接受了LSC，17名接受了SSLF联合阴式子宫切除术。所有手术均由一名外科医生完成。主要结局包括手术时间、并发症和住院时间。使用德国盆底问卷（Deutscher Beckenboden Fragebogen）、国王健康问卷（KHQ）和患者满意度调查评估生活质量。结果：患者组在ASA评分（p=0.023）和合并症方面存在显著差异，SSLF患者的发病率较高。LSC的手术时间较长（91（75-115）分钟对73（61-87）分钟，p=0.05），但并发症明显较少（0%对17.6%，p=0.02）。两种方法均显示膀胱功能、脱垂症状和盆底功能障碍评分有显著改善（均p<0.001）。在LSC组中观察到性功能评分的组内改善（p=0.002），但在SSLF组中没有（p=0.5）；组间变化评分比较不显著（p=0.8）。两组在住院时间或患者总体满意度方面没有显著差异（LSC:95%对SSLF:87%满意，p>0.05）。结论：两种手术方法均能有效治疗POP，患者满意度高。LSC与观察到的并发症较少和性功能评分组内改善有关；SSLF与手术时间较短有关，适用于发病率较高的患者。这些关联可能部分反映了组间的基线差异，并被视为假设生成。SSLF仍然适用于发病率较高的患者，同时尽量减少手术时间并避免特伦德伦堡体位是有利的。
Abstract
: Pelvic organ prolapse (POP) significantly impacts women's quality of life. Two established surgical approaches exist: laparoscopic sacropexy (LSC) and vaginal sacrospinous fixation (SSLF). This study compared surgical outcomes, complication rates, and quality of life between these techniques. : This retrospective monocentric study included 58 patients treated between 2020 and 2023: 41 underwent LSC, and 17 underwent SSLF with vaginal hysterectomy. All procedures were performed by a single surgeon. Primary outcomes included operative time, complications, and hospital stay. Quality of life was assessed using the German Pelvic Floor Questionnaire (Deutscher Beckenboden-Fragebogen), King's Health Questionnaire (KHQ), and patient satisfaction surveys. : Patient groups differed significantly in ASA scores ( = 0.023) and comorbidities, with SSLF patients showing higher morbidity. LSC demonstrated longer operative times (91 (75-115) vs. 73 (61-87) min, = 0.05) but significantly fewer complications (0% vs. 17.6%, = 0.02). Both methods showed significant improvements in bladder function, prolapse symptoms, and pelvic floor dysfunction scores (all < 0.001). A within-group improvement in sexual function scores was observed in the LSC group ( = 0.002) but not in the SSLF group ( = 0.5); the between-group comparison of change scores was not significant ( = 0.8). No significant differences were found between groups regarding hospital stay duration or overall patient satisfaction (LSC: 95% vs. SSLF: 87% satisfied, > 0.05). : Both surgical approaches effectively treat POP with high patient satisfaction. LSC was associated with fewer observed complications and a within-group improvement in sexual function scores; SSLF was associated with shorter operative time and was applied in patients with higher morbidity. These associations may partly reflect baseline differences between groups and are considered hypothesis-generating. SSLF remains suitable for patients with higher morbidity when minimizing operative time and avoiding Trendelenburg positioning is advantageous.
如何引用
AMA
Sima Ismayilova, Narmin Ismayilova, Jörg Engel, Anita Windhorst. Laparoscopic Sacropexy Versus Vaginal Sacrospinous Fixation for Pelvic Organ Prolapse: A Retrospective Comparison of Surgical Outcomes and Quality of Life.. Healthcare (Basel, Switzerland). 2026; doi:10.3390/healthcare14111469.
APA
Sima Ismayilova, Narmin Ismayilova, Jörg Engel, Anita Windhorst (2026). Laparoscopic Sacropexy Versus Vaginal Sacrospinous Fixation for Pelvic Organ Prolapse: A Retrospective Comparison of Surgical Outcomes and Quality of Life.. Healthcare (Basel, Switzerland). https://doi.org/10.3390/healthcare14111469
GB/T 7714
Sima Ismayilova, Narmin Ismayilova, Jörg Engel, Anita Windhorst. Laparoscopic Sacropexy Versus Vaginal Sacrospinous Fixation for Pelvic Organ Prolapse: A Retrospective Comparison of Surgical Outcomes and Quality of Life.[J]. Healthcare (Basel, Switzerland), 2026 doi:10.3390/healthcare14111469.
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