背景:目的是研究考虑未来生育的患者在腹腔镜骶结肠切除术(SCP)保留子宫后的妊娠结局和盆腔器官脱垂(POP)的复发。
方法:这是一项针对单一教学医院的回顾性研究。这项研究包括六名自发怀孕的年轻女性,腹腔镜SCP后。从接受腹腔镜SCP并在手术后怀孕的患者的医疗记录中检索数据。
结果:共有6名妇女自发受孕。其中两个怀孕了两次。怀孕总数被认为是8次。两次怀孕以自然流产告终;其中之一需要扩张和刮宫。足月进行了五次怀孕,一次妊娠在32周时早产结束。除1例早产外,所有新生儿均按各自胎龄体重适当,小于胎龄。在所有剖宫产期间均未报告术中困难。通过腹腔镜SCP后超过四年的客观评估记录了随访情况。未发现根尖脱垂复发。只有一个病人反复发作,症状,需要再次手术的二级膀胱膨出。
结论:希望生育并出现有症状的高级别POP的患者是腹腔镜SCP的良好候选者。我们的发现表明,腹腔镜SCP是一种有效的手术干预措施,不仅可以缓解有症状的POP,而且可以保留年轻女性的生育能力。
BACKGROUND: The objective is to study the pregnancy outcomes and the recurrence of pelvic organ prolapse (POP) following laparoscopic sacrocolpopexy (SCP) with uterine preservation in patients who are considering future fertility.
METHODS: This is a retrospective study in single teaching hospital. The study included six young women who conceived spontaneously, after laparoscopic SCP. Data were retrieved from the medical records of patients who underwent laparoscopic SCP and became pregnant after surgery.
RESULTS: A total of six women conceived spontaneously. Two of them got pregnant twice. The total number of pregnancies was considered to be eight. Two pregnancies ended in spontaneous miscarriages; one of them required dilatation and curettage. Five pregnancies were carried out to term, and one pregnancy ended by preterm delivery at 32 weeks. All the neonates were at appropriate weight as per their respective gestational ages except the one preterm delivery, which was small for gestational age. No intraoperative difficulties were reported during all cesarean sections. Follow-up was documented by objective assessment for more than four years post laparoscopic SCP. No recurrent apical prolapse was found. Only one patient had a recurrent, symptomatic, grade two cystocele that required reoperation.
CONCLUSIONS: Patients who desired fertility and presented with symptomatic high-grade POP were good candidates for laparoscopic SCP. Our findings demonstrate the visibility of laparoscopic SCP as an effective surgical intervention that not only levitates symptomatic POP but preserves fertility in young women.