手术减肥对盆腔器官脱垂的影响：一项荟萃分析。
Effect of Surgically Induced Weight Loss on Pelvic Organ Prolapse: A Meta-analysis.
机构信息
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, China.
Department of Structural Heart Disease, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
出版信息
Obes Surg. 2023 Nov;33(11):3402-3410. doi: 10.1007/s11695-023-06867-x. Epub 2023 Oct 7.
INTRODUCTION
Bariatric surgery alleviates certain aspects of pelvic floor disorder, but the effect on pelvic organ prolapse (POP) is unclear. To assess the effect of bariatric surgery on POP we conducted the present meta-analysis and firstly performed a subgroup analysis based on the duration of follow-up.
METHODS
Four databases including PubMed, The Cochrane Library, Web of Science, and Embase were searched to identify relevant studies published before February 24, 2023. The main outcome was the prevalence and severity of POP symptoms before and after bariatric surgery. Then we assessed the heterogeneity, publication bias and performed subgroup analyses based on follow-up time, study quality and region.
RESULTS
Eleven studies with a total of 696 participants met the inclusion criteria. The results showed that the prevalence of POP decreased after bariatric surgery (odds ratio[OR] = 2.29, 95% confidence interval[CI]: 1.05, 5.01; P = 0.04, I = 78%), with significant differences observed both at 3-6 months (OR = 2.24, 95% CI: 1.25, 4.01; P = 0.007, I = 59%) and 12 months (OR = 4.64, 95% CI: 2.83, 7.58; P < 0.0001, I = 0%) of follow-up compared with pre-surgery. Pelvic Organ Prolapse Distress Inventory scores 6-item also decreased after bariatric surgery (mean difference [MD] = 2.11, 95% CI: 0.32, 3.89; P = 0.02, I = 55%) with significant differences observed both at 3-6 months (MD = 3.72; 95% CI: [0.10, 7.34], P = 0.04, I = 70%) and ≥ 12 months (MD = 3.24; 95% CI: [0.56, 5.91], P = 0.02, I = 56%) of follow-up.
CONCLUSION
Bariatric surgery alleviated POP symptoms in women with obesity both during short-term (3-6 months) and long-term (≥ 12 months) follow-up.
简介
减重手术可以缓解某些盆腔功能障碍，但对盆腔器官脱垂（POP）的影响尚不清楚。为了评估减重手术对 POP 的影响，我们进行了本次荟萃分析，并首先根据随访时间进行了亚组分析。
方法
检索了包括 PubMed、The Cochrane Library、Web of Science 和 Embase 在内的四个数据库，以确定截至 2023 年 2 月 24 日发表的相关研究。主要结局是减重手术前后 POP 症状的患病率和严重程度。然后，我们评估了异质性、发表偏倚，并根据随访时间、研究质量和地区进行了亚组分析。
结果
共有 11 项研究，总计 696 名参与者符合纳入标准。结果显示，减重手术后 POP 的患病率下降（比值比[OR] = 2.29，95%置信区间[CI]：1.05，5.01；P = 0.04，I² = 78%），在 3-6 个月（OR = 2.24，95% CI：1.25，4.01；P = 0.007，I² = 59%）和 12 个月（OR = 4.64，95% CI：2.83，7.58；P < 0.0001，I² = 0%）的随访时均有显著差异。减重手术后盆腔器官脱垂严重程度评估问卷 6 项评分也下降（平均差值[MD] = 2.11，95% CI：0.32，3.89；P = 0.02，I² = 55%），在 3-6 个月（MD = 3.72；95% CI：[0.10，7.34]，P = 0.04，I² = 70%）和≥12 个月（MD = 3.24；95% CI：[0.56，5.91]，P = 0.02，I² = 56%）的随访时均有显著差异。
结论
在短期（3-6 个月）和长期（≥12 个月）随访中，减重手术均可减轻肥胖女性的 POP 症状。
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