Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Uroginecologia e Chirurgia Ricostruttiva del Pavimento Pelvico, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy.
Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Uroginecologia e Chirurgia Ricostruttiva del Pavimento Pelvico, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy.
Eur J Obstet Gynecol Reprod Biol. 2022 Oct;277:57-70. doi: 10.1016/j.ejogrb.2022.08.006. Epub 2022 Aug 12.
Laparoscopic uterosacral ligament suspension (LUSLS) of the vaginal apex for the treatment of pelvic organ prolapse (POP) has gained popularity. The aim of this systematic review is to investigate perioperative outcomes and complications, subjective and objective success rates and recurrence rates in women undergoing this surgical procedure.
A systematic literature search was performed in December 2021. The critical appraisal skills program (CASP) was used to assess the methodological quality of the selected studies. The Clavien-Dindo (CD) scale and the Satava scale were used to classify periprocedural complications. Continuous variables were described as means and standard deviations while categorical were expressed as percentages of the whole group. Statistical significance was set at p < 0.05.
26 articles were selected and analysed, with a total population of 1401 patients. Anatomical and subjective success rates after LUSLS ranged from 79% and 100% and from 76.2% to 100% respectively. The re-operation rate varied from 2% to 4.5% in the largest cohorts. The overall complication rate was 13.6%, however grade III CD complications occurred only in 1% of patients. Ureteral complications were described in only 2 cases.
LUSLS represent a safe and effective technique for vaginal apex resuspension in women with POP. Further larger prospective randomized studies are required to confirm these data.
腹腔镜子宫骶骨韧带悬吊术（LUSLS）治疗盆腔器官脱垂（POP）越来越受欢迎。本系统评价旨在调查接受该手术的女性的围手术期结果和并发症、主观和客观成功率以及复发率。
2021 年 12 月进行了系统文献检索。使用关键评估技能计划（CASP）评估所选研究的方法学质量。Clavien-Dindo（CD）量表和 Satava 量表用于对围手术期并发症进行分类。连续变量以平均值和标准差表示，而分类变量以整组的百分比表示。统计学意义设为 p<0.05。
共选择并分析了 26 篇文章，共有 1401 名患者。LUSLS 后的解剖学和主观成功率分别为 79%和 100%和 76.2%至 100%。最大队列中的再手术率从 2%到 4.5%不等。总体并发症发生率为 13.6%，但仅 1%的患者发生 CD 分级 III 并发症。仅在 2 例中描述了输尿管并发症。
LUSLS 是治疗 POP 患者阴道顶点脱垂的一种安全有效的技术。需要进一步进行更大规模的前瞻性随机研究来证实这些数据。
