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加拿大 2004-2014 年盆腔器官脱垂手术的地域差异和时间趋势

Regional Variation and Temporal Trends in Surgery for Pelvic Organ Prolapse in Canada, 2004-2014.

机构信息

Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC; Children's and Women's Hospital and Health Centre of British Columbia, Vancouver, BC; School of Population and Public Health, University of British Columbia, Vancouver, BC.

Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC.

出版信息

J Obstet Gynaecol Can. 2020 Jul;42(7):846-852.e5. doi: 10.1016/j.jogc.2019.12.016. Epub 2020 Mar 12.

DOI:10.1016/j.jogc.2019.12.016
PMID:32173237
Abstract

OBJECTIVES

We sought to examine temporal trends in pelvic organ prolapse (POP) surgery in Canada.

METHODS

In this observational cross-sectional study, we used diagnostic and procedure codes from all hospitalizations and outpatient clinic visits in Canada (excluding Québec) from 2004 to 2014 to identify and analyze data on POP surgery.

RESULTS

There were 204 301 POP surgery visits from 2004 to 2014, and the rate of POP surgery declined from 19.3 to 16.0 per 10 000 women during this period. The rates of "native tissue reconstructive repair" and "hysterectomy without other procedure" declined from 15.0 to 12.8 per 10 000 women and 2.6 to 1.6 per 10 000 women, respectively. The rate of obliteration increased from 0.1 to 0.3 per 10 000 women (all P values for trend <0.01). Mesh procedures increased from 1.6 per 10 000 women in 2004 to 2.4 per 10 000 women in 2007 and 2008, and then declined to 1.3 per 10 000 women in 2014. Reconstructive mesh surgery using an abdominal open approach declined, while laparoscopic procedures increased over the period examined.

CONCLUSION

The rates of POP surgery declined in Canada between 2004 and 2014. An increase was observed in obliteration procedures and in laparoscopic vaginal suspension and fixation with mesh.

摘要

目的

我们旨在研究加拿大盆腔器官脱垂(POP)手术的时间趋势。

方法

在这项观察性横断面研究中,我们使用了加拿大(魁北克除外)所有住院和门诊就诊的诊断和手术代码,从 2004 年至 2014 年对 POP 手术的数据进行了识别和分析。

结果

2004 年至 2014 年间共有 204 301 例 POP 手术就诊,在此期间,POP 手术的发生率从每 10 000 名女性 19.3 例降至 16.0 例。“固有组织修复重建”和“无其他手术的子宫切除术”的发生率分别从每 10 000 名女性 15.0 例和 2.6 例降至 12.8 例和 1.6 例。封闭术的发生率从每 10 000 名女性 0.1 例增加到 0.3 例(所有趋势 P 值均<0.01)。网片手术从 2004 年的每 10 000 名女性 1.6 例增加到 2007 年和 2008 年的每 10 000 名女性 2.4 例,然后在 2014 年降至每 10 000 名女性 1.3 例。经腹开放式重建网片手术减少,而腹腔镜手术在此期间增加。

结论

2004 年至 2014 年间,加拿大 POP 手术的发生率下降。封闭术以及腹腔镜阴道悬吊带和网片固定术的应用有所增加。

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