网片对比骶棘韧带固定术治疗阴道顶端脱垂的系统评价

doi:10.16260/j.cnki.1009-2188.2017.05.002

Chinese Journal of Modern Operative Surgery

2017, Vol. 21

Issue (5): 327-332 DOI: 10.16260/j.cnki.1009-2188.2017.05.002

Orginal Research

The Systematic Evaluation on Transvaginal Polypropylene Mesh versus Sacrospinous Ligament Fixation for Vaginal Vault Prolapse

WANG Su-fei, CHEN Yong, WANG Xiao-wen， YI Cun-jian

Department of Gynecology and Obstetrics, the First Affiliated Hospital of Yangtze University, Jingzhou 434000, Hubei, China

Abstract
Figure/Table
References
Related Citation (0)

Download:

HTML

PDF (952KB)
Export: BibTeX | EndNote (RIS)

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 metaanalysis 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. Metaanalysis 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（CRADI8, UDI6, PISQ12, 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 meshrelated complications, such as mesh extrusion and erosion. Still economic evaluations and prospective studies are needed to guide clinical practices.

Key words： sacrospinous ligament fixation Synthetic mesh vaginal vault prolapse Metaanalysis

Published: 25 May 2018

ZTFLH:

R711.74

Corresponding Authors: YI Cun-jian

	Service
	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	WANG Su-fei
	CHEN Yong
	WANG Xiao-wen， YI Cun-jian

Cite this article:

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[J]. Chinese Journal of Modern Operative Surgery, 2017, 21(5): 327-332.

URL:

http://www.surgerychina.com/EN/10.16260/j.cnki.1009-2188.2017.05.002 OR http://www.surgerychina.com/EN/Y2017/V21/I5/327

［1］	Beck RP, McCormick S, Nordstrom L.A 25year experience with 519 anterior colporrhaphy procedures［J］. Obstet Gynecol， 1991，78(6):10111018.
［2］	Olsen AL, Smith VJ, Bergstrom JO,et al.Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence［J］. Obstet Gynecol, 1997 ,89(4):501506.
［3］	张庆霞, 朱兰, 郎景和. 中盆腔缺陷的手术治疗［J］. 实用妇产科杂志, 2008, 24(5): 276279.
［4］	Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? ［J］. Control Clin Trials, 1996 ,17(1):112.
［5］	de Tayrac R, Mathé ML, Bader G, et al. Infracoccygeal sacropexy or sacrospinous suspension for uterine or vaginal vault prolapse ［J］. Int J Gynaecol Obstet, 2008,100(2):154159.
［6］	Lopes ED, Lemos NL, Carramo Sda S, et al. Transvaginal polypropylene mesh versus sacrospinous ligament fixation for the treatment of uterine prolapse: 1year followup of a randomized controlled trial ［J］. Int Urogynecol J, 2010,21(4):389394. doi: 10.1007/s0019200910521.
［7］	Halaska M, Maxova K, Sottner O, et al. A multicenter, randomized, prospective, controlled study comparing sacrospinous fixation and transvaginal mesh in the treatment of posthysterectomy vaginal vault prolapse［J］. Am J Obstet Gynecol, 2012,207(4):301.e1e7. doi: 10.1016/j.ajog.2012.08.016.
［8］	Sokol AI, Iglesia CB, Kudish BI, et al. Oneyear objective and functional outcomes of a randomized clinical trial of vaginal mesh for prolapse［J］. Am J Obstet Gynecol, 2012,206(1):86.e1e9. doi: 10.1016/j.ajog.2011.08.003.
［9］	Svabik K, Martan A, Masata J, et al. Comparison of vaginal mesh repair with sacrospinous vaginal colpopexy in the management of vaginal vault prolapse after hysterectomy in patients with levator ani avulsion: a randomizedcontrolled trial［J］. Ultrasound Obstet Gynecol, 2014 ,43(4):365371. doi: 10.1002/uog.13305.
［10］	Dos Reis Brando da Silveira S, Haddad JM, de JármyDi Bella ZI,et al.Multicenter, randomized trial comparing native vaginal tissue repair and synthetic mesh repair for genital prolapse surgical treatment［J］. Int Urogynecol J, 2015,26(3):335342. doi: 10.1007/s001920142501z.
［11］	Mant J, Painter R, Vessey M. Epidemiology of genital prolapse: observations from the Oxford Family Planning AssociationStudy［J］. Br J Obstet Gynaecol, 1997,104(5):579585.
［12］	Beer M, Kuhn A. Surgical techniques for vault prolapse: a review of the literature［J］. Eur J Obstet Gynecol Reprod Biol, 2005, 119(2):144155.
［13］	Kaufman Y, Singh SS, Alturki H, et al. Age and sexual activity are risk factors for mesh exposure following transvaginal mesh repair［J］.Int Urogynecol J, 2011,22(3):307313. doi: 10.1007/s0019201012706.
［14］	高桂香, 王鲁文, 刘冬霞, 等. 盆底重建术临床疗效及术后网片侵蚀暴露相关因素研究［J］. 现代妇产科进展, 2015, 24(11):844847.