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可调单切口迷你吊带(Ajust®)与其他吊带在女性压力性尿失禁手术治疗中的比较:有效性和并发症的荟萃分析。

Adjustable single-incision mini-slings (Ajust®) versus other slings in surgical management of female stress urinary incontinence: a meta-analysis of effectiveness and complications.

机构信息

Department of Urology, School of Medicine Hangzhou, Second Affiliated Hospital, Zhejiang University, No.88 Jiefang Road, Hangzhou, Zhejiang Province, People's Republic of China.

出版信息

BMC Urol. 2018 May 18;18(1):44. doi: 10.1186/s12894-018-0357-0.

DOI:10.1186/s12894-018-0357-0
PMID:29776405
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5960193/
Abstract

BACKGROUND

Adjustable single-incision mini-sling (SIMS) is a new category of SIMS for stress urinary incontinence (SUI). The aim of this study was to compare the efficacy and safety of adjustable single-incision mini-sling with other slings.

METHODS

Literature search in databases such as Pubmed, and Conchrane Library was performed up to December, 2015. The outcomes including cure rate, operation time, postoperative pain score and complications were reanalyzed. The pooled relative risk (RR) and mean difference (MD) with their 95% confidence interval (95% CI) were calculated by RevMan v5.0.

RESULTS

Eight studies with 1093 SUI female patients were included. There was no significant difference between adjustable SIMS and other slings (transobturator slings and MiniArc) in patients subjective cure rate and objective cure rate. In addition, adjustable SIMS was associated with a significantly shorter operative time and lower postoperative pain score when comparing adjustable SIMS with transobturator tape (MD = - 1.35; 95%CI: -2.24 to - 0.46, P = 0.003). For the complications, there was also no significant difference between adjustable SIMS and transobturator slings.

CONCLUSIONS

Adjustable SIMS had equally efficacy for SUI compared with transobturator slings and MiniArc. However, the significantly shorter operative time and lower postoperative pain score than transobturator tape supported the clinical application of adjustable SIMS.

摘要

背景

可调式单切口迷你吊带(SIMS)是治疗压力性尿失禁(SUI)的新型 SIMS。本研究旨在比较可调式单切口迷你吊带与其他吊带的疗效和安全性。

方法

检索 Pubmed 和 Cochrane 图书馆等数据库中的文献,检索截至 2015 年 12 月。重新分析治愈率、手术时间、术后疼痛评分和并发症等结果。采用 RevMan v5.0 计算合并相对风险(RR)和均数差值(MD)及其 95%置信区间(95%CI)。

结果

纳入 8 项研究共 1093 例 SUI 女性患者。可调式 SIMS 与其他吊带(经闭孔吊带和 MiniArc)在患者主观治愈率和客观治愈率方面无显著差异。此外,与经闭孔吊带相比,可调式 SIMS 手术时间更短,术后疼痛评分更低(MD=-1.35;95%CI:-2.24 至-0.46,P=0.003)。对于并发症,可调式 SIMS 与经闭孔吊带之间也无显著差异。

结论

可调式 SIMS 治疗 SUI 的疗效与经闭孔吊带和 MiniArc 相当。然而,与经闭孔吊带相比,其手术时间更短,术后疼痛评分更低,支持其在临床上的应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0ab/5960193/abd1e3cf98fe/12894_2018_357_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0ab/5960193/82daba89ce06/12894_2018_357_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0ab/5960193/b69315882251/12894_2018_357_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0ab/5960193/bf6015ba7f0d/12894_2018_357_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0ab/5960193/79424f5efaa6/12894_2018_357_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0ab/5960193/abd1e3cf98fe/12894_2018_357_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0ab/5960193/82daba89ce06/12894_2018_357_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0ab/5960193/b69315882251/12894_2018_357_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0ab/5960193/bf6015ba7f0d/12894_2018_357_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0ab/5960193/79424f5efaa6/12894_2018_357_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0ab/5960193/abd1e3cf98fe/12894_2018_357_Fig5_HTML.jpg

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