Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas.
Obstet Gynecol. 2022 Sep 1;140(3):412-420. doi: 10.1097/AOG.0000000000004901. Epub 2022 Aug 3.
To estimate the effect of concomitant supracervical hysterectomy compared with total hysterectomy during abdominal sacrocolpopexy on the rate of mesh erosion by performing a systematic review and meta-analysis of the existing literature.
From database inception through January 2022, we explored MEDLINE, Web of Science, EMBASE, CINAHL, ClinicalTrials.gov , and Cochrane Central Register of Controlled Trials. Studies comparing the rate of mesh erosion in women undergoing abdominal sacrocolpopexy who had concomitant supracervical hysterectomy compared with total hysterectomy were included.
Two reviewers separately ascertained studies, obtained data, and gauged study quality. The rate of mesh erosion was compared, and odds ratios (ORs) with 95% CIs were estimated.
TABULATION, INTEGRATION, AND RESULTS: Nineteen studies with 10,572 women who underwent abdominal sacrocolpopexy were identified, including 4,285 women in the supracervical group and 6,287 women in the total hysterectomy group. The overall mean postprocedure follow-up time was 30.7±15.1 months (median 12.4, range 1.5-44.2). The median (95% CI) point prevalence of mesh erosion was 0.36% (0-1.9%) in women who had supracervical hysterectomy compared with 3.8% (1.8-8.7%) in women who had total hysterectomy. The overall rate of mesh erosion in women who had supracervical hysterectomy was lower compared with women who had total hysterectomy (pooled OR 0.26, 95% CI 0.18-0.38, I 2 0%).
In women with symptomatic apical pelvic organ prolapse who undergo abdominal sacrocolpopexy with concomitant hysterectomy, supracervical hysterectomy is associated with a lower risk of mesh erosion compared with total hysterectomy.
PROSPERO, CRD42022301862.
通过系统评价和荟萃分析现有文献，估计在腹式骶骨阴道固定术中同时行子宫颈切除术与全子宫切除术相比，对补片侵蚀率的影响。
从数据库创建到 2022 年 1 月，我们检索了 MEDLINE、Web of Science、EMBASE、CINAHL、ClinicalTrials.gov 和 Cochrane 对照试验中心注册库。纳入了比较行腹式骶骨阴道固定术的女性中同时行子宫颈切除术与全子宫切除术的补片侵蚀率的研究。
两名审查员分别确定研究、获取数据并评估研究质量。比较了补片侵蚀率，并估计了比值比（OR）及其 95%置信区间（CI）。
列表、整合和结果：确定了 19 项研究，共纳入 10572 名行腹式骶骨阴道固定术的女性，其中子宫颈切除术组 4285 名，全子宫切除术组 6287 名。总体平均术后随访时间为 30.7±15.1 个月（中位数 12.4，范围 1.5-44.2）。子宫颈切除术组补片侵蚀的中位（95%CI）点患病率为 0.36%（0-1.9%），全子宫切除术组为 3.8%（1.8-8.7%）。与全子宫切除术相比，子宫颈切除术组的补片侵蚀总体发生率较低（汇总 OR 0.26，95%CI 0.18-0.38，I 2 0%）。
在因症状性中盆腔器官脱垂而行腹式骶骨阴道固定术的女性中，与全子宫切除术相比，同时行子宫颈切除术与补片侵蚀风险降低相关。
PROSPERO，CRD42022301862。
