网状物在子宫或阴道穹窿脱垂手术中应用的疗效及安全性的系统评价
Systematic review of the efficacy and safety of using mesh in surgery for uterine or vaginal vault prolapse.
作者信息
Jia Xueli, Glazener Cathryn, Mowatt Graham, Jenkinson David, Fraser Cynthia, Bain Christine, Burr Jennifer
机构信息
Health Services Research Unit, University of Aberdeen, Aberdeen AB25 2ZD, UK.
出版信息
Int Urogynecol J. 2010 Nov;21(11):1413-31. doi: 10.1007/s00192-010-1156-7. Epub 2010 Jun 15.
INTRODUCTION AND HYPOTHESIS
The aim of this study is to estimate efficacy and safety of mesh in surgery for uterine or vault prolapse.
METHODS
Seventeen electronic databases were searched for relevant studies that were published from 1980 onwards.
RESULTS
Fifty-four studies involving 7,054 women were included. For sacrocolpopexy (average follow-up 23 months), the risk of clinical recurrence ranged from 0% to 6%, persistent symptoms ranged from 3% to 31% and mesh erosion from 0% to 12%. For infracoccygeal sacropexy (average follow-up 13 months), the risk of clinical recurrence ranged from 0% to 25%, persistent symptoms from 2% to 21% and mesh erosion 0% to 21%. Limited evidence was available for sacrocolpoperineopexy and uterine suspension sling to draw reliable estimates.
CONCLUSIONS
Sacrocolpopexy was associated with a low risk of recurrence but with a relatively high risk of mesh erosion. Ranges of estimates for outcomes for other mesh techniques were wide.
引言与假设
本研究旨在评估网片在子宫或穹窿脱垂手术中的疗效与安全性。
方法
检索了17个电子数据库，查找1980年以来发表的相关研究。
结果
纳入了54项涉及7054名女性的研究。对于骶棘韧带固定术（平均随访23个月），临床复发风险为0%至6%，持续症状为3%至31%，网片侵蚀为0%至12%。对于尾骨下骶骨固定术（平均随访13个月），临床复发风险为0%至25%，持续症状为2%至21%，网片侵蚀为0%至21%。关于骶骨会阴固定术和子宫悬吊吊带术，仅有有限的证据可用于得出可靠的评估结果。
结论
骶棘韧带固定术复发风险较低，但网片侵蚀风险相对较高。其他网片技术的结果评估范围较广。
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