골반경하 천골질고정술 28예 임상연구
CLINICAL STUDY OF LAPAROSCOPIC SACROCOLPOPEXY FOR PELVIC ORGAN PROLAPSE
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초록
목적골반장기탈출증의 치료로 시행된 골반경하 천골질고정술의 실행가능성과 안전성에 관하여 평가하고자 한다. 연구방법Pelvic organ prolapse quantification (POP-Q) 체계를 이용하여 골반장기탈출증으로 진단받고 골반경하 천골질고정술을 시행받은 28예의의무기록을 조사하였다. 수술전ㆍ후의 임상적 지표, 합병증을 수술 전 · 후에 조사하였으며 적어도 수술 후 6개월간은 추적관찰을 하였다. 재발은 추적 관찰 기간 동안 POP-Q체계의 어느 한 부분이라도 2기 이상인 경우로 정의하였다. 결과31예에서 골반경하 천골질고정술을 시도하여 28예에서 가능하였으며 개복술로의 전환율은 9.7%였다. 28예의 평균연령은 56세(범위,34-69세)였으며, 동시에 53예의 요실금수술을 비롯한 다른 수술을 시행하였다. 평균 수술시간은 298분이었다. 3예의 수술 전 · 후 합병증이 있었는데, 5 mm 절개창의 혈종 1예, 배뇨장애 2예가 발생하였다. 수술 후 평균 20개월 추적관찰기간(범위, 6-70개월) 동안 삽입된 메시로 인한 합병증 또는 질탈출증이 재발하여 재수술한 예는 없었다. 결론골반경하 천골질고정술은 해부학적으로 높은 성공률과 낮은 합병증을 보여 골반장기탈출증을 치료하는데 실행 가능한 안전한 치료방법으로 생각된다.
Abstract
Objective The aim of our study is to describe the feasibility and safety of laparoscopic sacrocolpopexy for pelvic organ prolapse. Methods Twenty eight case series of laparoscopic sacrocolpopexy which were performed by the same surgeon were analysed retrospectively by reviewing medical records for peri- and postoperative data. Clinical outcomes and anatomical outcomes based on pelvic organ prolapse quantifi cation system were assessed pre- and postoperatively. Results Initially, thirty one cases were tried and three cases were converted to open surgery (9.7%). Twenty eight cases with a mean age of 56 years (range, 34-69 years) were performed. Fifty three cases of concomitant surgery were performed with laparoscopic sacrocolpopexy. The mean operation time was 298 minutes. The minor perioperative complications of 3 cases (a case of wound hematoma and 2 cases of voiding dysfunction) occurred. There was no reoperation related to mesh or recurrent prolapse for a mean follow-up period of 20 months (range, 6-70 months). Conclusion Our results confi rm that laparoscopic sacrocolpopexy is a feasible and safe surgical modality for pelvic organ prolapse.
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