Nosti Patrick A, Umoh Andy Uduak, Kane Sarah, White Dena E, Harvie Heidi S, Lowenstein Lior, Gutman Robert E
From the *FPMRS Division, Obstetrics and Gynecology Department, Medstar Washington Hospital Center, Georgetown University School of Medicine, Washington, DC; †FPMRS Division, Obstetrics and Gynecology Department, University of Pennsylvania, Philadelphia, PA; ‡Division of Urogynecology, Obstetrics and Gynecology Department, Case Western Reserve University, MetroHealth Medical Center; §FPMRS Division, Obstetrics and Gynecology Department, University of Oklahoma, Oklahoma City, OK; and ∥FPMRS Division, Obstetrics and Gynecology Department, Rambam Health Care Campus, Haifa, Israel.
Female Pelvic Med Reconstr Surg. 2014 Jan-Feb;20(1):33-7. doi: 10.1097/SPV.0000000000000036.
To compare perioperative and postoperative surgical outcomes between and among open and minimally invasive sacrocolpopexies (MISCs).
We performed a multicenter retrospective cohort study comparing abdominal sacrocolpopexy (ASC) and MISC from January 1999 to December 2010.
A total of 1124 subjects underwent sacrocolpopexy, with 589 ASCs and 535 MISCs. Within the MISC group, 273 were laparoscopic (LSC) and 262 were robotic (RSC). Abdominal sacrocolpopexy was associated with greater overall complication rate compared with MISC (20.0% vs 12.7%; P = 0.001). After controlling for difference in length of follow-up, there was no significant difference in the rate of anatomical failure between the ASC and MISC groups. The MISC group had shorter hospitalization, less blood loss, but longer operative times compared with the ASC group. When comparing LSC to RSC, there was no difference in anatomic failures (7.7% vs 6.9%; P = 0.74). However, LSC was associated with more complications compared with RSC (18% vs 7%; P < 0.02). In addition, LSC had higher blood loss, less operative time, and shorter hospital stay compared with RSC.
Although anatomic results are similar, ASC is associated with a higher rate of complications compared with MISC.
比较开放性和微创性骶骨阴道固定术（MISC）围手术期及术后的手术结果。
我们进行了一项多中心回顾性队列研究，比较1999年1月至2010年12月期间的腹式骶骨阴道固定术（ASC）和MISC。
共有1124名受试者接受了骶骨阴道固定术，其中589例为ASC，535例为MISC。在MISC组中，273例为腹腔镜手术（LSC），262例为机器人手术（RSC）。与MISC相比，腹式骶骨阴道固定术的总体并发症发生率更高（20.0%对12.7%；P = 0.001）。在控制随访时间差异后，ASC组和MISC组之间的解剖学失败率无显著差异。与ASC组相比，MISC组住院时间更短，失血量更少，但手术时间更长。当比较LSC和RSC时，解剖学失败率无差异（7.7%对6.9%；P = 0.74）。然而，与RSC相比，LSC的并发症更多（18%对7%；P < 0.02）。此外，与RSC相比，LSC失血量更多，手术时间更短，住院时间更短。
虽然解剖学结果相似，但与MISC相比，ASC的并发症发生率更高。
