Clinical Study Of Vaginal Stump Suspension Suture Technique In Laparoscopic Total Hysterectomy

OBJECTIVE:To investigate the effects of reconstruction of sacral ligament-cardinal ligament-vagina loop by U-suspension suture the stump of round ligament,sacral ligament,cardinal ligament,infundibulopelvic ligament and the side of vagina stump in pelvic organ prolapse and quality of life for patients with Laparoscopic Total Hysterectomy.METHODS:A total of 119 patients with benign uterine diseases were treated in Shanxian People's Hospital from January 2015 to May 2016.51 patients were treated with Laparoscopic Total Hysterectomy+vaginal stump side suspension suture.69 patients were treated with Laparoscopic Total Hysterectomy.The pelvic organ prolapse evaluation indicator(POP-Q)and the length of vaginal were evaluated at 1,3,and 6 months after surgery.Quality of Life Questionnaire score(PFDI-20?POSQ-12)was used to evaluate quality life of patients.RESULTS:?There were no significant differences in age,previous obstetric history,disease distribution,PFID-20,average bleeding volume,and average operation duration in observation group and control group(P>0.05).?POP-Q at 1,3,and 6 months after surgeryPoint C measurements were-8.6 ±0.54,-8.21 ±0.66 and-8.13 ±0.72 in observation group and-5.34±0.44,-5.24 ±0.32and-5.00 ± 0.43 in control group at 1,3,and 6 months after surgery.Significant difference was observed(P<0.05).Point Aa measurements were-2.1 ±0.78,-2.21 ±0.34and-2.67 ±0.43 in observation group and-1.85 ± 0.57,-0.76 ± 0.54and-0.65 ? 0.01 in control group at 1,3,and 6 months after surgery.Significant difference was observed(P<0.05).Point Ba measurements were-2.44 ±0.52,-2.35 ±0.22and-2.24 ±0.44 in observation group and-2.00 ±0.00,-2.12 ± 0.11and-1.27 ± 0.22 in control group at 1,3,and 6 months after surgery.Significant difference was observed(P<0.05).Point Ap measurements were-2.3 ±0.54,-2.22 ±0.32and-2.23 ±0.64 in observation group and-1.70 ± 0.80,-0.60 ±0.03and-0.77 ? 1.02 in control group at 1,3,and 6 months after surgery.Significant difference was observed(P<0.05).Point Bp measurements were-2.5 ±0.47.-2.65 ±0.43and-2.33 ±0.54 in observation group and-1.0 ±0.00,-1.05 ± 0.11 and-1.08 ± 0.22 in control group at 1,3,and 6 months after surgery.Significant difference was observed(P<0.05).?Scores of PFDI-20 in two groups at 6 months and 12 months after the operation compared with the preoperative score were significantly different(p<0.05).The Quality of Life Questionnaire score were 21.22 ± 12.7,16.89±9.13and 18.44 ±9.54 in observation group and 65.5 ±21.6,63.6 ±2.08 and 63.6 ±8.5 in control group at 1,3,and 6 months after surgery.The score of control group was higher than the observation group in the 6 and 12 months after the operation.(P<0.05).?There had significant difference of scores of POSQ-12 between observation groups and control group.In the 6?12 months after the operation,the score of POSQ-12 of observation group was higher than the control group.CONCLUSIONS:U-suspension suture the stump of round ligament,sacral ligament,cardinal ligament,infundibulopelvic ligament and the side of vagina stump to rebuild the sacral ligament-cardinal ligament-vagina loop could prevent pelvic organ prolapse and improve quality of life for patients underwent Laparoscopic Total Hysterectomy.