全腹腔镜下阴道骶骨固定术和阴腹联合腹腔镜阴道骶骨固定术并发症的比较  

Comparison of Complications between Total Laparoscopic Sacral Colpopexy and Combined Transabdominal-Transvaginal Laparoscopic Sacral Colpopexy

作　　者：陈礼全[1] 张晓薇[1] 梁雪早 王苏[1] 林晓婷 徐丽珍[1] CHEN Liquan;ZHANG Xiaowei;LIANG Xuezao(Pelvic Center of The First Affiliated Hospital of Guangzhou Medical University,Guangzhou Guangdong 510120,China)

机构地区：[1]广州医科大学附属第一医院盆底中心,广东广州510120

出　　处：《实用妇产科杂志》2020年第8期610-614,共5页Journal of Practical Obstetrics and Gynecology

基　　金：广东省医学科学技术研究基金(编号:B2020078)。

摘　　要：目的:探讨全腹腔镜下阴道骶骨固定术和阴腹联合腹腔镜阴道骶骨固定术并发症的差异。方法:回顾性分析2013年1月1日至2018年12月31日在广州医科大学附属第一医院妇产科因"阴道穹隆脱垂"行全腹腔镜下阴道骶骨固定术的38例患者(全腹腔镜组)和因"子宫阴道脱垂"行"阴腹联合"腹腔镜阴道骶骨固定术的161例患者(阴腹联合组)的临床资料。结果:全腹腔镜组及阴腹联合组所有患者均顺利完成手术,均无术中并发症的发生。术中出血量59.2±37.9 ml vs 74.8±45.4 ml,手术时间74.47±8.4分钟vs 107.6±6.5分钟,术后停留导尿管时间2.3±1.0天vs 2.3±0.9天,术后住院天数5.6±1.6天vs 5.5±1.8天,两组间术后停留导尿管时间及术后住院天数两组差异无统计学意义(P>0.05)。而术中出血及手术时间两组差异有统计学意义(P<0.05)。全腹腔镜组及阴腹联合组患者均无一例发生术中并发症,围手术期并发症为:发热2.6%vs 1.2%,尿潴留7.9%vs 5.6%;远期并发症为网片相关并发症5.3%vs 5.0%。两组间术后病率、尿潴留发生率及网片相关并发症差异均无统计学意义(P>0.05)。结论:与全腹腔镜下阴道骶骨固定术相比,阴腹联合腹腔镜阴道骶骨固定术并没有增加围手术期感染率及网片相关并发症,是一种安全可靠的手术方式。Objective:To compare the complications of total Laparoscopic Sacrocolpopexy and combined transabdominal-transvaginal Laparoscopic Sacrocolpopexy.Methods:We retrospectively analyzed the clinical data of 38 patients underwenttotal laparoscopic sacral colpopexy for"vault prolapse"and 161 patients underwent combined"transabdominal-transvaginal"Laparoscopic Sacrocolpopexy for"uterine vaginal prolapse".Results:All the patients of both groups successfully completed the operation without intraoperative complications.The estimated blood loss in the two groups was similar 59.2±37.9 ml vs.74.8±45.4 ml.The difference between the two groups was not statistically significant in postoperative urethral catheter residence days 5.6±1.6 d vs.5.5±1.8 d days.After operation,there was no significant difference between the two groups(P>0.05).There was significant difference in intraoperative bleeding and operative time between the two groups(P<0.05).There were no intraoperative complications in both groups.Perioperative complications were fever 2.6%vs.1.2%,urinary retention 7.9%vs.5.6%.A long-term complication was 5.3%vs.5.0%.mesh-related complications postoperative disease rate,urinary retention rate and mesh-related complications were not significantly different between the two groups(P>0.05).A long-term complication was 5.3%vs.5.0%.mesh-related complications postoperative disease rate,urinary retention rate and mesh-related complications were not significantly different between the two groups(P>0.05).Conclusions:Compared with total laparoscopic vaginal sacral fixation,"vaginal abdominal combined"laparoscopic vaginal sacral fixation does not increase perioperative infection rate and mesh-related complications,which is a safe and reliable operation.

关 键 词：全腹腔镜下阴道骶骨固定术 “阴腹联合”腹腔镜阴道骶骨固定术 手术并发症 

分 类 号：R713.3[医药卫生—妇产科学]