From the Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics, Gynecology, and Women's Health, University of Louisville, Louisville, KY.
Female Pelvic Med Reconstr Surg. 2020 Aug;26(8):526-529. doi: 10.1097/SPV.0000000000000773.
The objective of this study was to compare perioperative outcomes of autologous bladder neck fascial slings (ABNFS) between rectus fascia and fascia lata harvest sites.
We analyzed women undergoing ABNFS in the 2006 to 2015 American College of Surgeons National Surgical Quality Improvement Program database, separating rectus fascia and fascia lata harvest sites by Current Procedural Terminology codes. We compared the 2 harvest sites for perioperative outcomes within 30 days including adverse events, readmission, and reoperation as well as operative time and length of hospital stay. The primary outcome was a composite of postoperative adverse events, readmission, and reoperation. A multivariable logistic regression model was used incorporating race, smoking status, surgical specialty, anesthesia class, concurrent procedures, body mass index, operating time, and length of hospital stay.
A total of 161 women in the database underwent ABNFS: 126 (78.3%) rectus fascia and 35 (21.7%) fascia lata harvest. Patients undergoing rectus fascial harvest were more likely to be white (140 [90.5%] rectus vs 26 [74.3%] fascia lata, P=0.02) and more likely to have ABNFS by a urologist (117 [93%] rectus vs 23 [66%] fascia lata, P < 0.01). There were no significant differences in operative time, length of stay, rate of reoperation, nonserious or serious adverse events, or readmission between the 2 harvest site groups. The 2 harvest sites had similar composite morbidity (adjusted odds ratio of 0.88 for rectus fascia; 95% confidence interval, 0.21-3.75; P=0.87).
Rectus fascia and fascia lata harvest for ABNFS have similar perioperative outcomes.
本研究旨在比较腹直肌筋膜和阔筋膜自体膀胱颈悬吊带（ABNFS）在围手术期的结局。
我们分析了 2006 年至 2015 年美国外科医师学会国家手术质量改进计划数据库中接受 ABNFS 的女性患者，根据当前操作术语代码将腹直肌筋膜和阔筋膜采集部位分开。我们比较了 2 个采集部位在 30 天内的围手术期结局，包括不良事件、再入院和再次手术以及手术时间和住院时间。主要结局是术后不良事件、再入院和再次手术的综合指标。采用多变量逻辑回归模型，纳入种族、吸烟状况、手术专业、麻醉分级、同时进行的手术、体重指数、手术时间和住院时间。
数据库中共有 161 名女性接受了 ABNFS：126 名（78.3%）采用腹直肌筋膜采集，35 名（21.7%）采用阔筋膜采集。接受腹直肌筋膜采集的患者更可能是白人（140 名[90.5%]腹直肌与 26 名[74.3%]阔筋膜，P=0.02），且更可能由泌尿科医生进行 ABNFS（117 名[93%]腹直肌与 23 名[66%]阔筋膜，P<0.01）。2 个采集部位组之间的手术时间、住院时间、再次手术率、非严重或严重不良事件或再入院率均无显著差异。2 个采集部位的复合发病率相似（腹直肌筋膜的调整比值比为 0.88；95%置信区间，0.21-3.75；P=0.87）。
腹直肌筋膜和阔筋膜采集用于 ABNFS 的围手术期结局相似。
