Objective:Pelvic organ prolapse(POP)is a common gynecological disease in middle-aged and older women that seriously affects patients'physical health and quality of life,increases the financial burden for patients,...Objective:Pelvic organ prolapse(POP)is a common gynecological disease in middle-aged and older women that seriously affects patients'physical health and quality of life,increases the financial burden for patients,and becomes a major public health concern.The aim of this study was to investigate the medium-term outcomes of laparoscopic pubocervical fascia reconstruction and sacrospinous ligament fixation with a posterior approach for patients with severe POP.Methods:Patients with severe POP quantitation stage III-IV who underwent laparoscopic pubocervical fascia reconstruction and sacrospinous ligament fixation with a posterior approach at the Department of Obstetrics and Gynecology,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine between September 2016 and December 2020 were enrolled in this study.The results and complications were recorded.Data were retrospectively reviewed.Results:In total,124 patients were analyzed.Patients were followed up for 32.2712.90 months.The objective cure rate for patients who underwent hysterectomy was 917%(100/109),with 7(6.4%)patients had anterior vaginal wall prolapse and 2(1.8%)patients had posterior vaginal wall prolapse.The objective cure rate for patients who retained uterus was 66.7%(10/15).All 5 patients with recurrence had uterine prolapse,and 3(20.0%)of them also had anterior vaginal wall prolapse.Conchusions:Laparoscopic pubocervical fascia reconstruction and sacrospinous ligament fixation with the posterior approach is a safe,minimally invasive,and effective method for patients with severe POP.Long-term follow-up is needed to confirm the clinical effects.展开更多
Objective:Laparoscopic pelvic lymph node dissection(LPND),which is an effective therapy for endometrial cancer,is challenging because of the complexity of the procedure and the occurrence of postoperative complication...Objective:Laparoscopic pelvic lymph node dissection(LPND),which is an effective therapy for endometrial cancer,is challenging because of the complexity of the procedure and the occurrence of postoperative complications.This study aimed to explore whether indocyanine green(ICG)-enhanced nearinfrared(NIR)fluorescence-guided LPND is superior to LPND in the context of early-stage endometrial carcinoma.Methods:In this retrospective study,we included the medical records of 190 patients with early-stage endometrioid adenocarcinoma who underwent LPND at the Department of Obstetrics and Gynecology,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine between January 2019 and January 2021.Depending on whether ICG-enhanced NIR fluorescence guidance was used,the patients were assigned to the ICG group or non-ICG group.Patients were followed-up for one year after surgery.Data on demographic characteristics,pathological results,operative outcomes,and complications were collected and analyzed.Results:The baseline characteristics were comparable between the ICG group and non-ICG group,including age,BMI,pregnancy history,and preoperative hemoglobin.For surgical outcomes,the patients in ICG group had significantly lower intraoperative blood loss(50 mL vs.120 mL,p<0.001),less postoperative pelvic drainage time(4.14±1.44 d vs.5.70±1.89 d,p¼0.001),shorter duration of hospital stay(5.26±1.41 d vs.7.37±1.85 d,p¼0.003),higher number of positive pelvic lymph nodes(PLNs)(1 vs.0,p¼0.003),and more PLN-positive cases(16.0%vs.3.6%,p¼0.003)than the patients in non-ICG group.However,no significant differences were noted in blood transfusion requirement,operative time,hemoglobin level decreases,number of PLNs harvested,or the presence of lymphocysts between the two groups.Conclusion:Our study showed that ICG-enhanced NIR fluorescence-guided operation may improve the accuracy and safety of LPND.展开更多
基金supported by the National Key Research and Development Program of China(2018YFC1004800)the Scien-tific Research Fund of Zhejiang Provincial Education Department(Y2020433-40)。
文摘Objective:Pelvic organ prolapse(POP)is a common gynecological disease in middle-aged and older women that seriously affects patients'physical health and quality of life,increases the financial burden for patients,and becomes a major public health concern.The aim of this study was to investigate the medium-term outcomes of laparoscopic pubocervical fascia reconstruction and sacrospinous ligament fixation with a posterior approach for patients with severe POP.Methods:Patients with severe POP quantitation stage III-IV who underwent laparoscopic pubocervical fascia reconstruction and sacrospinous ligament fixation with a posterior approach at the Department of Obstetrics and Gynecology,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine between September 2016 and December 2020 were enrolled in this study.The results and complications were recorded.Data were retrospectively reviewed.Results:In total,124 patients were analyzed.Patients were followed up for 32.2712.90 months.The objective cure rate for patients who underwent hysterectomy was 917%(100/109),with 7(6.4%)patients had anterior vaginal wall prolapse and 2(1.8%)patients had posterior vaginal wall prolapse.The objective cure rate for patients who retained uterus was 66.7%(10/15).All 5 patients with recurrence had uterine prolapse,and 3(20.0%)of them also had anterior vaginal wall prolapse.Conchusions:Laparoscopic pubocervical fascia reconstruction and sacrospinous ligament fixation with the posterior approach is a safe,minimally invasive,and effective method for patients with severe POP.Long-term follow-up is needed to confirm the clinical effects.
基金supported by the Medical and Health Research Project of Zhejiang Province(2018RC008,2018KY113,and WKJ-ZJ-2125)Zhejiang Provincial Natural Science Foundation(LQ20H040011).
文摘Objective:Laparoscopic pelvic lymph node dissection(LPND),which is an effective therapy for endometrial cancer,is challenging because of the complexity of the procedure and the occurrence of postoperative complications.This study aimed to explore whether indocyanine green(ICG)-enhanced nearinfrared(NIR)fluorescence-guided LPND is superior to LPND in the context of early-stage endometrial carcinoma.Methods:In this retrospective study,we included the medical records of 190 patients with early-stage endometrioid adenocarcinoma who underwent LPND at the Department of Obstetrics and Gynecology,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine between January 2019 and January 2021.Depending on whether ICG-enhanced NIR fluorescence guidance was used,the patients were assigned to the ICG group or non-ICG group.Patients were followed-up for one year after surgery.Data on demographic characteristics,pathological results,operative outcomes,and complications were collected and analyzed.Results:The baseline characteristics were comparable between the ICG group and non-ICG group,including age,BMI,pregnancy history,and preoperative hemoglobin.For surgical outcomes,the patients in ICG group had significantly lower intraoperative blood loss(50 mL vs.120 mL,p<0.001),less postoperative pelvic drainage time(4.14±1.44 d vs.5.70±1.89 d,p¼0.001),shorter duration of hospital stay(5.26±1.41 d vs.7.37±1.85 d,p¼0.003),higher number of positive pelvic lymph nodes(PLNs)(1 vs.0,p¼0.003),and more PLN-positive cases(16.0%vs.3.6%,p¼0.003)than the patients in non-ICG group.However,no significant differences were noted in blood transfusion requirement,operative time,hemoglobin level decreases,number of PLNs harvested,or the presence of lymphocysts between the two groups.Conclusion:Our study showed that ICG-enhanced NIR fluorescence-guided operation may improve the accuracy and safety of LPND.
