PDF(Pubmed)
Abstract：
UNASSIGNED: Pelvic organs prolapse remains a significant health concern affecting millions of women worldwide. The use of native tissues to suspend the apex has acquired relevance in urogynecologic surgery. One of the most commonly used procedures performed without mesh is the technique described by Shull, consisting of suturing the vaginal apex to the uterosacral ligaments. The objective of the study is to evaluate the learning curve of laparoscopic Shull\'s repair for the correction of pelvic floor defects, including the surgery time and surgical outcomes.
UNASSIGNED: This is a retrospective study conducted at the Policlinico G. Martino, University of Messina, Messina, Italy, and Policlinico Vanvitelli, Vanvitelli University, Naples, Italy. All patients affected by grade I-IV POP, consisting of apical prolapse with or without cystocele, and who underwent laparoscopic Shull\'s technique for prolapse correction were enrolled. The endpoints to estimate the learning curve for the procedure were the percentage of laparoscopic procedures completed, operative time, and the early complication rate.
UNASSIGNED: A total of 31 laparoscopic Shull repairs were collected for the study. To evaluate the learning curve of the technique, we divided the 31 cases into three different groups: Procedures 0-10; 11-20; 21-31. The parameter for evaluating technique learning was the operative time. Group 21-31 demonstrated an operative time of 97 min (SD 20), compared with 121 min (SD 23) in group 0-10 and 120 min (SD 13) in group 11-20. A comparison of these means through ANOVA showed a p-value of 0.01 for the entire system, and 0.95 for the comparison between 0 and 10 and 11-20, 0.04 for 0-10 vs. 21-31, and 0.02 between 11 and 20 and 21-31.
UNASSIGNED: The rate of surgical improvement in terms of time became effective after an average of 20 procedures. However, the improvement seems to be effective case by case for surgeons skilled in basic endoscopy.
UNASSIGNED: This is a retrospective study conducted at the Policlinico G. Martino, University of Messina, Messina, Italy, and Policlinico Vanvitelli, Vanvitelli University, Naples, Italy. All patients affected by grade I-IV POP, consisting of apical prolapse with or without cystocele, and who underwent laparoscopic Shull\'s technique for prolapse correction were enrolled. The endpoints to estimate the learning curve for the procedure were the percentage of laparoscopic procedures completed, operative time, and the early complication rate.
UNASSIGNED: A total of 31 laparoscopic Shull repairs were collected for the study. To evaluate the learning curve of the technique, we divided the 31 cases into three different groups: Procedures 0-10; 11-20; 21-31. The parameter for evaluating technique learning was the operative time. Group 21-31 demonstrated an operative time of 97 min (SD 20), compared with 121 min (SD 23) in group 0-10 and 120 min (SD 13) in group 11-20. A comparison of these means through ANOVA showed a p-value of 0.01 for the entire system, and 0.95 for the comparison between 0 and 10 and 11-20, 0.04 for 0-10 vs. 21-31, and 0.02 between 11 and 20 and 21-31.
UNASSIGNED: The rate of surgical improvement in terms of time became effective after an average of 20 procedures. However, the improvement seems to be effective case by case for surgeons skilled in basic endoscopy.
摘要：
盆腔器官脱垂仍然是影响全世界数百万妇女的重大健康问题。在泌尿妇科手术中，使用天然组织悬挂顶点已获得相关性。在没有网格的情况下执行的最常用程序之一是Shull描述的技术，包括将阴道尖缝合到子宫骶骨韧带。该研究的目的是评估腹腔镜Shull修复术矫正盆底缺损的学习曲线，包括手术时间和手术结果。
■这是一项在PoliclinicoG.Martino进行的回顾性研究，梅西纳大学,Messina,意大利,还有PoliclinicoVanvitelli,VanvitelliUniversity,那不勒斯,意大利。所有受I-IV级POP影响的患者，包括有或没有膀胱膨出的顶端脱垂，并纳入接受腹腔镜Shull技术脱垂矫正的患者。评估手术学习曲线的终点是完成腹腔镜手术的百分比，手术时间,和早期并发症发生率。
■共收集了31例腹腔镜修补术用于研究。为了评估该技术的学习曲线，我们将31例患者分为三组：程序0-10；11-20；21-31。评估技术学习的参数是手术时间。21-31组的手术时间为97分钟（SD20），与0-10组121min(SD23)和11-20组120min(SD13)比较。通过方差分析对这些方法的比较表明，整个系统的p值为0.01，0和10与11-20之间的比较为0.95，0-10与21-31，11和20以及21-31之间为0.02。
■在平均20次手术后，手术时间上的改善率变得有效。然而,对于熟练进行基本内窥镜检查的外科医生来说，这种改进似乎是有效的。
■这是一项在PoliclinicoG.Martino进行的回顾性研究，梅西纳大学,Messina,意大利,还有PoliclinicoVanvitelli,VanvitelliUniversity,那不勒斯,意大利。所有受I-IV级POP影响的患者，包括有或没有膀胱膨出的顶端脱垂，并纳入接受腹腔镜Shull技术脱垂矫正的患者。评估手术学习曲线的终点是完成腹腔镜手术的百分比，手术时间,和早期并发症发生率。
■共收集了31例腹腔镜修补术用于研究。为了评估该技术的学习曲线，我们将31例患者分为三组：程序0-10；11-20；21-31。评估技术学习的参数是手术时间。21-31组的手术时间为97分钟（SD20），与0-10组121min(SD23)和11-20组120min(SD13)比较。通过方差分析对这些方法的比较表明，整个系统的p值为0.01，0和10与11-20之间的比较为0.95，0-10与21-31，11和20以及21-31之间为0.02。
■在平均20次手术后，手术时间上的改善率变得有效。然而,对于熟练进行基本内窥镜检查的外科医生来说，这种改进似乎是有效的。
