Guérin Sonia, Suzman Evan, Alhalabi Feras, Lutz Kevin, Zimmern Philippe
Department of Urology, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9110, USA.
Department of Gynecology Obstetrics, Rennes University Hospital, Rennes, France.
J Robot Surg. 2024 Dec 13;19(1):25. doi: 10.1007/s11701-024-02185-1.
To assess the very long-term functional outcomes and complications of robot-assisted sacrocolpopexy (RASC) at our institution where this robotic technology for pelvic organ prolapse (POP) repair has been available since 2006. A retrospective review of a cohort of women who underwent a RASC was performed by an investigator not involved in the clinical care of these patients. Women with no electronic medical record follow-up in the last 2 years were contacted by telephone. The primary outcome was RASC success defined as (1) no self-report of vaginal bulge, (2) no prolapse beyond the hymen (POP-Q > 0), and (3) no retreatment for prolapse (surgery, pessary). Postoperative symptomatic urinary incontinence (UI), anorectal dysfunction, dyspareunia and any late complication were secondary outcomes. Of 100 women who underwent RASC between 2007 and 2018, 79 patients with a median age of 66 years (IQR 58-71) were included. Median follow-up was 69 months (28-117), with a last visit more than 5 years postoperatively in 48 patients and more than 10 years in 19 patients. A total of 59 patients (75%) met the definition of success. A bothersome vaginal bulge was reported in 18 patients (23%), prolapse beyond the hymen was observed in 12 patients (16%), and further surgery for POP was performed in 9 patients (12%). Twenty-three patients reported postoperative UI (32%) and 21 reported postoperative anorectal dysfunction (39%). RASC provided good long-term results with an unpredictable risk of recurrence independent of the timeline.
自2006年起，我院便已具备用于盆腔器官脱垂（POP）修复的机器人技术。为评估我院机器人辅助骶骨阴道固定术（RASC）的长期功能结局及并发症，由一名未参与这些患者临床护理的研究人员对一组接受RASC手术的女性进行了回顾性研究。对过去2年无电子病历随访的女性进行了电话随访。主要结局为RASC成功，定义为：（1）无阴道膨出的自我报告；（2）处女膜外无脱垂（POP-Q＞0）；（3）无需因脱垂进行再次治疗（手术、子宫托）。术后症状性尿失禁（UI）、肛门直肠功能障碍、性交困难及任何晚期并发症为次要结局。在2007年至2018年间接受RASC手术的100名女性中，纳入了79例患者，中位年龄为66岁（四分位间距58-71岁）。中位随访时间为69个月（28-117个月），48例患者术后最后一次随访时间超过5年，19例患者超过10年。共有59例患者（75%）符合成功定义。18例患者（23%）报告有令人困扰的阴道膨出，12例患者（16%）观察到处女膜外脱垂，9例患者（12%）因POP接受了进一步手术。23例患者报告术后出现UI（32%），21例患者报告术后出现肛门直肠功能障碍（39%）。RASC提供了良好的长期结果，但复发风险不可预测，且与时间线无关。
