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年龄对微创骶骨阴道固定术后围手术期并发症的影响。

The Impact of Age on Perioperative Complications After Minimally Invasive Sacrocolpopexy.

机构信息

From the Department of Obstetrics and Gynecology.

Division of Female Pelvic Medicine and Reconstructive Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC.

出版信息

Female Pelvic Med Reconstr Surg. 2021 Jun 1;27(6):351-355. doi: 10.1097/SPV.0000000000000859.

Abstract

OBJECTIVE

Our aim was to compare perioperative complications between older (≥65 years), middle-age (55-64 years), and younger (<55 years) women after minimally invasive sacrocolpopexy (SCP).

METHODS

This retrospective cohort study included women undergoing SCP from 2006 to 2016 at a single academic center. Our primary outcome was the rate of perioperative complications (intraoperative and postoperative within 6 weeks of surgery), between groups. Secondary outcomes included readmission and reoperation rates.

RESULTS

There were 440 consecutive participants: 159 (36.1%) older, 160 (36.4%) middle-age, and 121 (27.5%) younger women. The overall intraoperative complication rate from SCP was 9.1%, with the most common being cystotomy (5.0%) and vaginotomy (1.8%). There were no differences in intraoperative complications between groups. Urinary tract infection (10.9%) and port-site cellulitis (3.4%) were the most common postoperative complications. For our primary outcome, younger women had a higher rate of postoperative complications compared with middle-age and older women (P < 0.001). There was no difference in postoperative complications between older and middle-aged women. In a multivariate regression controlling for comorbidity, body mass index, diabetes, smoking status, concomitant hysterectomy, and/or sling, younger women retained a higher rate of postoperative complications (odds ratio, 1.7 [1.2,2.2]). Rates of readmission (3.2%) and reoperation (0.7%) were also similar between groups.

CONCLUSIONS

The rate of perioperative complications was low with no difference in intraoperative complications. Women under 55 had a higher rate of postoperative complications compared to women age 55 to 65 years and those older than 65 years. Our results suggest that it is reasonable to offer SCP to women older than 65 years.

摘要

目的

比较经微创骶骨阴道固定术(SCP)治疗的老年(≥65 岁)、中年(55-64 岁)和年轻(<55 岁)女性的围手术期并发症。

方法

本回顾性队列研究纳入了 2006 年至 2016 年在一家学术中心接受 SCP 的女性。我们的主要结局是组间围手术期并发症(术中及术后 6 周内)发生率。次要结局包括再入院率和再次手术率。

结果

共纳入 440 例连续患者:159 例(36.1%)为老年组,160 例(36.4%)为中年组,121 例(27.5%)为年轻组。SCP 的总体术中并发症发生率为 9.1%,最常见的是膀胱切开术(5.0%)和阴道切开术(1.8%)。各组间术中并发症无差异。尿路感染(10.9%)和切口部位蜂窝织炎(3.4%)是最常见的术后并发症。对于我们的主要结局,年轻女性术后并发症发生率高于中年和老年女性(P<0.001)。老年和中年女性术后并发症发生率无差异。在多变量回归中,控制合并症、体重指数、糖尿病、吸烟状况、同时行子宫切除术和/或吊带后,年轻女性术后并发症发生率仍较高(比值比,1.7[1.2,2.2])。各组间再入院率(3.2%)和再次手术率(0.7%)也相似。

结论

围手术期并发症发生率低,术中并发症无差异。与 55 岁至 65 岁女性和 65 岁以上女性相比,55 岁以下女性术后并发症发生率更高。我们的结果表明,对于 65 岁以上女性,行 SCP 是合理的。

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