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Updated: Sep 14, 2025

Laparoscopic Non-Mesh Cerclage Pectopexy for Pelvic Organ Prolapse

Laparoscopic Non-Mesh Cerclage Pectopexy for Pelvic Organ Prolapse

Published on: September 13, 2022

在预防早产的过程中,穿越腹腔与穿越阴道的宫圈:系统性审查和元分析

Stergios Bobotis¹, Elisavet Arsenaki², Kirsty Hamilton³

¹Department of Surgery, Tunbridge Well and Maidstone NHS Trust, Tunbridge Wells, UK.

American journal of obstetrics and gynecology

|July 18, 2025

概括

通过阴道的 cerclage (TAC) 与通过阴道的 cerclage (TVC) 相比,可以降低围产死亡率和早产. 然而,由于研究的局限性和异质性,需要更多的研究.

科学领域:

产科和妇科产科和妇科
围产儿医学围产儿医学
手术创新在外科创新.

背景情况:

过早分娩仍然是新生儿发病率和死亡率的主要原因.
子宫带是预防高风险怀孕中早产的一种程序.
通过阴道的宫 cerclage (TVC) 和通过腹部的宫 cerclage (TAC) 是两个主要的手术方法.

研究的目的:

为了比较 transabdominal cerclage (TAC) 与 transvaginal cerclage (TVC) 在产科和围产期结局方面的有效性.
评估不同外科手术方法对早产率和围产死亡率的影响.

主要方法:

在PubMed,Scopus和Web of Science数据库中进行了系统的文献搜索,直到2024年1月.
包括的研究是随机和观察性,评估了患早产风险的妇女接受TVC或TAC.
使用RoB-2和ROBINS-I工具提取并评估质量的数据,并使用随机效应模型计算聚合风险比率 (RR) 和95%置信区间 (CI).

主要成果:

通过阴道的围 (TAC) 与通过阴道的围 (TVC) 相比,与显著较低的围产死亡率 (RR 0.36,95% CI 0.14-0.95) 和早产 (RR 0.49,95% CI 0.25-0.94) 相关.
由于包括的研究具有显著的异质性和观察性,对这些发现的信心很低.
二次分析表明,在开放式和腹腔镜 TAC 方法之间,围产死亡率或早产率没有显著差异.

结论:

在减少围产死亡率和早产的过程中,跨腹腔环膜 (TAC) 显示出潜在的优势,而不是通过阴道环膜 (TVC),特别是在以前的TVC失败或禁忌的情况下.
由于研究异质性和观察设计,目前的数据是不确定的.
需要进一步进行高质量的研究,以确定TAC作为高风险怀孕的最终治疗选择.

关键词:

围绕着一个圈子.宫性衰竭是什么意思 laparoscopic 腹腔镜检查腹腔镜检查腹腔镜检查腹腔镜检查开放式的圈套圈套过早分娩的出生时间.穿越腹部穿越腹部通过阴道穿过阴道.

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