Department of Obstetrics and Gynecology, University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey.
Department of Obstetrics & Gynecology, Ege University School of Medicine, Izmir, Turkey.
Int Braz J Urol. 2018 Sep-Oct;44(5):996-1004. doi: 10.1590/S1677-5538.IBJU.2017.0692.
To investigate differences in perioperative complications and short-term outcomes of patients who underwent abdominal sacrocolpopexy / sacrohysteropexy, laparoscopic sa-crocolpopexy / sacrohysteropexy, or laparoscopic pectopexy due to apical prolapse.
A retrospective cohort study was performed on 110 patients who underwent apical prolapse surgery between January 1, 2011, and July 31, 2017. Only symp-tomatic uterine or vaginal vault prolapse patients with stage 2-4, according to the pelvic organ prolapse quantification system, were included. Baseline and intraoperative variables of groups; perioperative complications, including hemorrhage, urinary, and wound complications, blood transfusion, ileus, and short-term outcomes were compared.
A total of 68 abdominal sacrocolpopexies (44 sacrocolpopexies and 24 sa-crohysteropexies), 14 laparoscopic sacrocolpopexies (10 sacrocolpopexies and 4 sa-crohysteropexies), and 28 laparoscopic pectopexies (16 pectopexies and 12 pectohys-teropexies) were analyzed. Baseline characteristics and intraoperative variables were similar. However, the mean operating time was significantly shorter in the laparoscopic pectopexy group (74.9 min) when compared with that of the other groups (p < 0.01). During the six-month follow-up period, no prolapse recurrence and mesh erosion / exposure were observed in any group. De-novo stress urinary incontinence, urgency, and defecation problems, as well as perioperative complication rates, were not statistically significantly different between the groups.
Although the complication rates and short-term outcomes were not significantly different between the groups, minimally invasive approaches were associated with reduced procedural-related morbidity. Laparoscopic pectopexy is a promising endoscopic prolapse surgery and can be an alternative technique to sacrocolpopexy.
探讨因子宫或阴道穹窿顶脱垂而行腹式骶骨阴道固定术/骶骨子宫固定术、腹腔镜骶骨阴道固定术/骶骨子宫固定术或腹腔镜前盆修补术的患者围手术期并发症和短期结局的差异。
对 2011 年 1 月 1 日至 2017 年 7 月 31 日期间行子宫或阴道穹窿顶脱垂手术的 110 例患者进行回顾性队列研究。仅纳入有症状的、符合盆腔器官脱垂定量系统 2-4 期的子宫或阴道穹窿顶脱垂患者。比较各组的基线和术中变量；比较围手术期并发症（包括出血、尿和伤口并发症、输血、肠梗阻）和短期结局。
共分析了 68 例腹式骶骨阴道固定术（44 例骶骨阴道固定术和 24 例骶骨子宫固定术）、14 例腹腔镜骶骨阴道固定术（10 例骶骨阴道固定术和 4 例骶骨子宫固定术）和 28 例腹腔镜前盆修补术（16 例前盆修补术和 12 例前盆子宫修补术）。基线特征和术中变量相似。然而，与其他两组相比，腹腔镜前盆修补组的平均手术时间明显缩短（74.9 分钟）（p < 0.01）。在 6 个月的随访期间，任何一组均未观察到脱垂复发和网片侵蚀/暴露。新发压力性尿失禁、尿急和排便问题以及围手术期并发症发生率在各组之间无统计学差异。
尽管各组的并发症发生率和短期结局无显著差异，但微创方法与减少与手术相关的发病率有关。腹腔镜前盆修补术是一种有前途的内镜脱垂手术，可作为骶骨阴道固定术的替代技术。
