ABSTRACT
Objective To investigate the effect of bilateral sacrospinous ligament fixation by Pavlik harness method in the treatment of pelvic organ prolapse (POP). Methods Sixty patients with POP received operation were divided into bilateral sacrospinous ligament fixation by Pavlik harness method group (study group,30 cases),posterior intravaginal sling plasty group (P-IVS group, 15 cases) and sacrospinous ligament fixation group (SSLF group, 15 cases) by random digits table. The data of the three groups, such as operation time, bleeding during the operation, indwelling urinary catheter time, duration out of bed after operation, cure rate, recurrence rate and the quality of sexual life were observed. Results The operation time in study group [( 30.5 ± 5.3 ) min] was significantly shorter than that in SSLF group [(43.5 ± 10.6) min](P ＜ 0.05 ), and the duration out of bed in study group [( 1.5 ± 0.6) d] was earlier than that in SSLF group [(3.1 ±0.7) d] and P-IVS group [(3.3 ±0.8) d](P＜0.05). The POP-Q stage of all the patients being hospital was 0 or Ⅰ , approached the cure standard. Patients were followed up for 3-16 months after operation, the recurrence rate and the decrease of the quality of sexual life in study group [0,3.3%(1/30)]were lower than those in P-IVS group [20.0%(3/15),13.3%(2/15)] and SSLF group[6.7%(1/15),26.7%(4/15)] (P ＜ 0.05). Conclusion Bilateral sacrospinous ligament fixation by Pavlik harness method is a simple, firm operation, and the position of vagina does not axialitily change and suits the anatomy, so it is effective and worth spreading clinically to treat the POP.
ABSTRACT
ObjectiveTo investigate the clinical features of borderline ovarian tumor (BOT).MethodThe clinical features, clinical stage, malignant potential, pathological type, the positive rate of serum CA125 were analyzed in 60 patients with pathological diagnosis of BOT. ResultsSerous cystadenoma was the main pathological type, accounted for 60.0％ (36/60). The occurrence of focal canceration in serous cystadenoma[22.2％ (8/36)]was higher than that in mucinous cystadenoma[5.3％(1/19)](P＜ 0.05). The positive rate of CA125 was 51.7％(31/60). The positive rate of CA125 in BOT with micro-dip or focal canceration[65.0％(13/20) and 81.8％(9/11)]was higher than that in simple BOT [31.0％(9/29)](P＜O.05),but there was no significant difference between BOT with micro-dip and BOT with focal canceration (P＞ 0.05 ). ConclusionsBOT is low malignant potential and preoperative diagnosis is difficult because of the typical clinical symptoms. CA125 is not sensitive to pure BOT. Women of childbearing age should regularly check for ovarian tumor by ultrasonography and preoperative serum CA125 test can be combined with micro-dip on the BOT and those made with preoperative focal predict cancer diagnosis. Aggressive surgical treatment is necessarily as soon as possible and rapid intraoperative pathological examination to reduce cancer risk.
ABSTRACT
Objective To investigate the surgical strategy of recurrent rectuvaginal fistula. Methods Retrospectivly analyzed the clinical data of 13 patients with recurrent rectovaginal fistula from December 2001 to December 2008. The etiopathogenisis and the ways of treatment were analyzed. Results All the 13 patients with a transverse colostomy surgical repaired with Mason operation in the secondary intention,and recepted closure of colostomy in the third intention for treatment, all patients were cured. No recurrent fistula was identified with postoperative follow-up 4 - 84 months. Conclusions After recurrent rectovaginal fistula with multiple surgical treatment,the blood supply of local tissue is poor,the scar is serious. Selecting the appropriate timing of operation, adequate preoperative preparation, the application of transverse colostomy and Mason operation in different period could significantly enhance the successful operation rate.