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机器人辅助骶骨阴道固定术的围手术期、术后和解剖学结果。

Perioperative, postoperative and anatomical outcomes of robotic sacrocolpopexy.

机构信息

University of Texas Medical Branch, Galveston, TX, USA.

Acibadem Hospital, Istanbul, Turkey.

出版信息

J Obstet Gynaecol. 2021 May;41(4):651-654. doi: 10.1080/01443615.2020.1789958. Epub 2020 Oct 12.

Abstract

The study aimed to analyse the anatomical, perioperative and postoperative outcomes of the robotic-assisted sacrocolpopexy (RSCP). After obtaining Institutional Review Board (IRB #19-0167) approval, our retrospective case series included 144 consecutive patients that underwent an RSCP for symptomatic stage II pelvic organ prolapse (POP) or symptomatic/asymptomatic stage III/IV POP. Patient information included operative parameters, perioperative and postoperative complications, readmissions and reoperation. Demographics and baseline characteristics were summarised by frequencies and percentages for categorical variables, and by mean/median, standard deviation, and ranges for continuous variables. In our study, concomitant surgeries with sacrocolpopexy consisted of hysterectomy, Burch colposuspension and midurethral sling. The anatomical success rate was 87.5% and the reoperation rate was 10.4%. The mean follow-up time was 12.5 (±8.7) months. Intraoperative complications 13 (9%) were bowel serosal abrasion, bladder wall injuries, trochar site bleeds, subcutaneous emphysema and a retroperitoneal haematoma. Our results suggest that RSCP is a feasible and safe approach for the treatment of POP with a low complication rate and favourable medium-term outcomes regarding anatomical and symptomatic results.Impact statement Pelvic organ prolapse affects more than 25% of women in the United States. Apical and anterior compartment defects are challenging cases and sacrocolpopexy is considered the gold standard treatment option for apical and anterior compartment defects. As technology has advanced, minimally invasive approaches have been popular with their pros. We present the highest volume case series in the literature from our tertiary care centre for robotic-assisted sacrocolpopexy (RSCP). Our results suggest that RSCP is a feasible and safe approach for the treatment of POP with a low complication rate and favourable 1-year outcomes regarding anatomical and subjective results. Robotic-assisted sacrocolpopexy has the potential to gain more popularity in the near future based on accumulating data on its feasibility and safety results.

摘要

这项研究旨在分析机器人辅助骶骨阴道固定术(RSCP)的解剖、围手术期和术后结果。在获得机构审查委员会(IRB #19-0167)批准后,我们的回顾性病例系列纳入了 144 例连续接受 RSCP 治疗症状性 II 期盆腔器官脱垂(POP)或症状性/无症状性 III/IV 期 POP 的患者。患者信息包括手术参数、围手术期和术后并发症、再入院和再次手术。采用频率和百分比表示分类变量,采用均值/中位数、标准差和范围表示连续变量,对人口统计学和基线特征进行总结。在我们的研究中,与骶骨阴道固定术同时进行的手术包括子宫切除术、Burch 阴道悬吊术和中尿道吊带术。解剖成功率为 87.5%,再次手术率为 10.4%。平均随访时间为 12.5(±8.7)个月。术中并发症 13 例(9%)为肠浆膜磨损、膀胱壁损伤、套管针部位出血、皮下气肿和腹膜后血肿。我们的结果表明,RSCP 是治疗 POP 的一种可行且安全的方法,具有低并发症发生率和有利的中期解剖和症状结果。

声明

盆腔器官脱垂影响美国超过 25%的女性。顶前间隙缺陷是具有挑战性的病例,骶骨阴道固定术被认为是顶前间隙缺陷的金标准治疗选择。随着技术的进步,微创方法因其优点而受到欢迎。我们展示了来自我们三级保健中心的文献中最高容量的机器人辅助骶骨阴道固定术(RSCP)病例系列。我们的结果表明,RSCP 是治疗 POP 的一种可行且安全的方法,具有低并发症发生率和有利的 1 年解剖和主观结果。

机器人辅助骶骨阴道固定术在获得更多关于其可行性和安全性的研究数据的情况下,在不久的将来可能会更受欢迎。

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