单孔改良微小穿刺孔与传统多孔腹腔镜侧腹壁悬吊术治疗中重度盆腔器官脱垂的疗效及安全性比较OA

Objective:To compare the efficacy and safety of modified single-port micropuncture laparoscopic lat-eral suspension(MSPLLS)with those of traditional multi-port laparoscopic lateral suspension(TPLLS)in the treat-ment of moderate to severe pelvic organ prolapse(POP).Methods:A prospective randomized controlled study was conducted.60 patients with moderate to severe POP[POP quantitative staging system(POP-Q)≥Stage III]trea-ted at Chengdu First People's Hospital from January 9,2023,to March 29,2024,were included and randomly as-signed to the MSPLLS group(n=30)or the TPLLS group(n=30)using a random number table.Patients were fol-lowed up for 12 months.Perioperative parametres,postoperative pain(VAS)scores,changes in pelvic organ pro-lapse quantification(POP-Q)stage,improvement in subjective symptoms(assessed by PFDI-20 and PFIQ-7),scar cosmesis(evaluated by POSAS),scar aesthetics,patient satisfaction and complication rates were compared be-tween the two groups.Results:There were no significant differences between the MSPLLS and TPLLS groups in operative time,estimated intraoperative blood loss,or length of hospital stay(P>0.05).The MSPLLS group had significantly lower VAS scores at 6,24,and 48 hours postoperatively compared to the TPLLS group(P<0.05).There were no significant differences in intraoperative,early postoperative,or long-term complications,nor in recurrence rates or anatomical success rates(defined as POP-Q stage≤Ⅰ)at 12 months between the two groups(P>0.05).Both groups exhibited significant reductions in PFDI-20 and PFIQ-7 scores at 6 and 12 months postoperatively(P<0.05).No statistically significant differences in PFDI-20 or PFIQ-7 scores were observed between the MSPLLS and TPLLS groups preoperatively or at 6 and 12 months postoperatively(P>0.05).The MSPLLS group showed signifi-cantly better total POSAS scores,cosmetic VAS scores,and patient satisfaction than the TPLLS group(P<0.05).Conclusions:Both MSPLLS and TPLLS are safe and effective options for the treatment of moderate to severe POP,with comparable therapeutic efficacy.MSPLLS demonstrates significant advantages in reducing postoperative pain and improving scar cosmesis,thereby better aligning with the principles of minimally invasive surgery.It is wor-thy of clinical promotion and application.