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題 名 | Laparoscopic Presacral Neurectomy for Chronic Pelvic Pain=腹腔鏡薦骨前神經切除術對慢性骨盆腔疼痛之治療 |
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作 者 | 陳芳萍; | 書刊名 | 長庚醫學 |
卷 期 | 23:1 2000.01[民89.01] |
頁 次 | 頁1-7 |
分類號 | 416.293 |
關鍵詞 | 慢性骨盆腔疼痛; 骨盆神經切除術; 腹腔鏡薦骨前神經切除術; Chronic pelvic pain; Pelvic denervation; Iaparoscopic presacral neurectomy; |
語 文 | 英文(English) |
英文摘要 | Presacral neurectomy is an effective treatment for chronic pelvic pain and dysmenorrhea. The theory behind presacral neurectomy for pain relief is based upon the anatomy of the sensory pathways from the pelvic viscera through the inferior and superior hypogastric plexus, located in the presacral area, to the spinal columns. The excision of the presacral nerve trunk can obstruct pain sensory pathways. Unfortunately 20-25% of patients treated medically for severe, disabling pelvic pain fail to show improvement. As a result, presacral neurectomy has become an alternative management for those with chronic pelvic pain and dysmenorrhea, especially for those who have failed to respond to medical treatment. Operative endoscopy further facilitates the adaptation of the laparoscopic approach to this pelvic denervation. The efficacy of pain relief by laparoscopic presacral neurectomy in chronic pelvic pain and dysmenorrhea is documented at about 75-80%. Major complications are rare with a rate of less than 1% reported. Laparoscopic presacral neurectomy therefore offers an effective alternative treatment and should also be considered as the initial surgical intervention for chronic pelvic pain. |
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