| BackgroundPelvic organ prolapse is a common disease in middle-aged and elderly women, have been reported in the literature at present the incidence of pelvic organ prolapse rate was 19.7%. POP-Q stage Ⅱ degrees above the pelvic organ prolapse treatment is still the operation treatment, the traditional operation vaginal hysterectomy (Trans vaginal hysterectomy, TVH)+ anterior and posterior vaginal wallrepair, is still widely used. With the wide application of laparoscopy in gynecologic field, laparoscopic assisted vaginal hysterectomy (Laparoscopic assisted vaginalhy sterectomy, LAVH) of pelvic reconstruction after years of development, technology has become increasingly mature,has become one of the main surgical treatment of pelvic organ prolapse; two surgical methods have their advantages and disadvantages, to evaluate the clinicaleffect of two kinds of operation the way, in the hope to effectively improve the cure rate of POP.ObjectiveEvaluation on the application (LAVH) and vaginal top suspension in the treatment of moderate to severe the effect and safety of pelvic organ prolapse, to explore the operation of the clinical significance and application value.MethodA retrospective analysis from 2011 March to 2013 May in our hospital for operation treatment of 64 cases of pelvic organ prolapse patients, divided into two groups:group Ⅰ for (LAVH) and vaginal top suspension (reconstruction group) 32 cases, Ⅱ group before and after TVH+ repair of vaginal wall (traditional group) 32 cases, clinical curative effect comparison of two groups of patients and the influence on the quality of life of the patients.Result1. General information:age, menopausal age, pregnant times, production time, BMI, there was no statistically significant difference degree of uterine prolapse comparison (P> 0.05).2. Perioperative data:reconstruction group operating time average (102.34±17.18) min, intraoperative blood loss (61.56±14.39) ml, postoperative urine tube indwelling time (3.28±0.46) d, anal exhaust time:(41.69±7.12)h, the traditional group (114.84±13.11) min, respectively, (95.63±18.31)ml, (3.84±0.77)d, (50.09±7.68)h, is similar between the two groups was statistically significant (P<0.05). Reconstruction group of postoperative hospitalization days:the average (4.81±0.64) d, traditional group average (4.88±0.71) d. Incidence of postoperative complications:reconstruction group in 2 cases of postoperative cause abdominal pain,1 case of perineum edema,4 cases with urinary retention. Set of 3 cases with traditional abdominal pain,2 cases with perineum edema,3 cases of urinary retention, there was no significant difference between the two groups (P> 0.05).3. Objective curative effect:reconstruction group of postoperative recurrence in 2 cases (6.25%),1 year conventional group of postoperative recurrence of 8 cases (25%); Compare two groups of postoperative 3 months and 6 months after the objective curative rate, there was no statistically significant difference (P>0.05), postoperative 1 year objective cure rate comparison betweentheitvro groups, with significant difference (P< 0.05); Objective curativeeiBfect of reconstruction group is significantly higher than the traditional group.4. The subjective efficacy comparison between the two groups of patients with PFIQ-7 and PFDI-20 score:reconstruction group and the traditional group after PFIQ-7, PFDI-20 score than before surgery were significantly decreased (P< 0.05), but the reconstruction group after 6 months and 1 year after operation, PFIQ-7 and PFDI-20 was lower than that in the traditional group (P<0.05). Heavy construction group is higher than that of the traditional group subjective effect.ConclusionThe advantage of LAVH pelvic floor reconstructive surgery is minimally invasive operation, on the body of small trauma, quick postoperative recovery, can better repair of pelvic defects, low recurrence rate after operation, has incomparable advantages over the traditional operation mode of operation for pelvic floor repair, is worthy of clinical application. |
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