Bazzi Ali A, Osmundsen Blake C, Hagglund Karen H, Aslam Muhammad Faisal
Division of Urogynecology and Reconstructive Pelvic Surgery, Legacy Health, Portland, OR.
Female Pelvic Med Reconstr Surg. 2019 Mar/Apr;25(2):105-108. doi: 10.1097/SPV.0000000000000654.
In this study, we assessed the difference in anatomical outcomes using the barbed, self-anchoring, delayed absorbable suture when compared with the traditional knot-tying interrupted suture technique during vaginal mesh attachment in robotic sacrocolpopexy. In addition, we compared the rates of mesh erosion with the 2 techniques.
This is a retrospective cohort study of 131 women who underwent minimally invasive robotic sacrocolpopexy at 2 sites. There were 65 subjects at site 1 (barbed, self-anchoring, delayed absorbable suture) and 66 from site 2 (traditional knot-tying technique). The primary outcome was anatomical success (measured by all Pelvic Organ Prolapse Quantification System points <0 postsurgery) in the barbed suture technique at site 1 compared with the traditional knot-tying technique at site 2. The secondary outcome was mesh erosion rates at these sites.
In the barbed suture group, performed at site 1, 98% (n = 59/60) had postoperative success at the 3-month follow-up period compared with 62% (n = 40/65) in the traditional knot-tying group at site 2 during the 12-month postoperative follow-up (P < 0.0001). During this time period, 2% (n = 1) in the barbed suture group and 8% (n = 5) in the traditional knot-tying group experienced sacrocolpopexy mesh erosion (P = 0.208).
Our results indicate that the barbed, self-anchoring, delayed absorbable suture is associated with less anatomical failures compared with traditional knot tying. The use of barbed suture is a safe technique and can be adopted in place of the traditional knot-tying technique. We also found less mesh erosion in the barbed suture group.
在本研究中，我们评估了在机器人骶骨阴道固定术中阴道网片附着时，使用倒刺、自锚定、延迟吸收缝线与传统打结间断缝合技术相比，在解剖学结果上的差异。此外，我们比较了两种技术的网片侵蚀率。
这是一项对131名在两个地点接受微创机器人骶骨阴道固定术的女性进行的回顾性队列研究。地点1有65名受试者（使用倒刺、自锚定、延迟吸收缝线），地点2有66名受试者（使用传统打结技术）。主要结局是地点1使用倒刺缝线技术与地点2使用传统打结技术相比，解剖学成功（通过术后所有盆腔器官脱垂定量系统评分<0来衡量）。次要结局是这些地点的网片侵蚀率。
在地点1进行的倒刺缝线组中，98%（n = 59/60）在术后3个月随访时有成功的结果，而地点2的传统打结组在术后12个月随访时为62%（n = 40/65）（P < 0.0001）。在此期间，倒刺缝线组有2%（n = 1）发生骶骨阴道固定术网片侵蚀，传统打结组有8%（n = 5）发生（P = 0.208）。
我们的结果表明，与传统打结相比，倒刺、自锚定、延迟吸收缝线导致的解剖学失败较少。使用倒刺缝线是一种安全的技术，可替代传统打结技术。我们还发现倒刺缝线组的网片侵蚀较少。
