Abstract: ObjectiveTo evaluate the effectiveness and safety of transvaginal polypropylene mesh versus sacrospinous ligament fixation for vaginal vault prolapse.MethodsCochrane Library、Pubmed、EMBASE、CNKI and CQVIP database were searched by computer for published randomised controlled trials(RCTs) from January 1980 to February 2017. The index words included sacrospinous ligament fixation, SSLF, POP and mesh. Two researchers extracted the data and evaluated the literature quality independently, to make a metaanalysis of surgery related data and clinical efficacy.ResultsA total of 6 randomized controlled trials were included, including overall 566 cases of female patients, in which 285 cases of synthetic mesh repair and 281 cases of sacrospinous ligament fixation. Metaanalysis showed that operation time was significantly longer in the mesh group than that in the SSLF group ［MD=9.75， 95％CI（3.09, 16.41）, P=0.004］. It didn’t decrease intraoperative blood loss ［MD=-21.43, 95%CI(-61.61, 18.75), P=0.30］ and the number of transfusion ［OR=0.94 ，95％CI(0.16, 5.42），P=0.95］ in the mesh group. It failed to the increase of objective cure rate ［OR=0.56 ,95％CI（0.28, 1.12），P=0.10］ or the quality of life（CRADI8, UDI6, PISQ12, P>0.05） either. There were no statistic differences in perioperative complications between the synthetic mesh group and the sacrospinous ligament fixation group(P>0.05).ConclusionsComparing with sacrospinous ligament fixation, the use of the synthetic mesh for the treatment of female vaginal vault prolapse can not increase the objective and subjective cure rate, or increase other postoperative complications. However the synthetic mesh repairs may result in the complications of meshrelated complications, such as mesh extrusion and erosion. Still economic evaluations and prospective studies are needed to guide clinical practices.
王夙斐,陈勇, 王晓雯,易村犍. 网片对比骶棘韧带固定术治疗阴道顶端脱垂的系统评价[J]. 中国现代手术学杂志, 2017, 21(5): 327-332.
WANG Su-fei, CHEN Yong, WANG Xiao-wen， YI Cun-jian. The Systematic Evaluation on Transvaginal Polypropylene Mesh versus Sacrospinous Ligament Fixation for Vaginal Vault Prolapse. Chinese Journal of Modern Operative Surgery, 2017, 21(5): 327-332.
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2017, Vol. 21 
