Heusinkveld John, Khandekar Maithili, Winget Veronica, Tigner Alyssa, Addis Ilana
Department of Obstetrics and Gynecology, University of Arizona, Tucson, AZ (Drs Heusinkveld, Winget, Tigner, and Addis).
University of Arizona College of Medicine, Tucson, AZ (Ms Khandekar).
AJOG Glob Rep. 2023 Jul 17;3(3):100254. doi: 10.1016/j.xagr.2023.100254. eCollection 2023 Aug.
Laparoscopic pectopexy is an alternative to sacrocolpopexy that was first reported in 2010. This procedure has been performed at our hospital since 2019 in patients with contraindications to sacrocolpopexy.
This study aimed to compare the outcomes of 50 cases of pectopexy with historical outcomes data for sacrocolpopexy.
This was a retrospective review of 50 laparoscopic pectopexies performed from July 2020 to July 2022 at an academic tertiary referral center; this was the second reported use of this technique in North America. The outcomes from laparoscopic pectopexy were compared with laparoscopic sacrocolpopexy performed at the same institution by the same surgeons (n=207). The primary outcomes were complication rate, rate of recurrent prolapse (stage II or greater), and reoperation.
Overall complication rates were 6.0% for pectopexy and 16.5% for sacrocolpopexy (relative risk, 0.79; =.65). Recurrent prolapse was seen among 2.0% of patients who underwent pectopexy and 6.3% of patients who underwent sacrocolpopexy at most recent follow-up (relative risk, 1.27; =.66). The rates of reoperation were 2.0% for pectopexy and 3.9% for sacrocolpopexy (relative risk, 1.04; =.96). The average operative times were 138 minutes for pectopexy and 158 minutes for sacrocolpopexy. The average lengths of follow-up were 88.1 days for pectopexy and 325.5 for sacrocolpopexy.
Although pectopexy was typically employed in patients with extensive pelvic adhesions or other conditions that placed them at higher risk of complications, both the success rate and the adverse event rate were similar to those in the historical cohort who underwent sacrocolpopexy. Although sacrocolpopexy remains the gold standard operation for apical prolapse, our data suggest that pectopexy can be employed to offer similar outcomes in many patients with contraindications to sacral fixation. These data give us increasing confidence that we can counsel our patients that this operation is likely to produce an outcome similar to a sacrocolpopexy.
腹腔镜耻骨后阴道固定术是骶骨阴道固定术的一种替代方法，于2010年首次报道。自2019年以来，我院对有骶骨阴道固定术禁忌证的患者实施了该手术。
本研究旨在比较50例耻骨后阴道固定术的结果与骶骨阴道固定术的历史结果数据。
这是一项对2020年7月至2022年7月在一家学术性三级转诊中心进行的50例腹腔镜耻骨后阴道固定术的回顾性研究；这是该技术在北美地区第二次被报道使用。将腹腔镜耻骨后阴道固定术的结果与同一机构由同一组外科医生实施的腹腔镜骶骨阴道固定术（n = 207）的结果进行比较。主要结局指标为并发症发生率、复发脱垂率（II期或更严重）和再次手术率。
耻骨后阴道固定术的总体并发症发生率为6.0%，骶骨阴道固定术为16.5%（相对风险，0.79；P = 0.65）。在最近一次随访中，接受耻骨后阴道固定术的患者中有2.0%出现复发脱垂，接受骶骨阴道固定术的患者中有6.
