Hadizadeh Alireza, Chill Henry H, Leffelman Angela, Paya-Ten Claudia, Chang Cecilia, Goldberg Roger P, Abramowitch Steven D, Rostaminia Ghazaleh
Division of Urogynecology, University of Chicago Pritzker School of Medicine, NorthShore University HealthSystem, 9650 Gross Point Road, Suite 3900, Skokie, IL, 60076, USA.
NorthShore University HealthSystem Research Institute, Evanston, IL, USA.
Int Urogynecol J. 2025 Apr;36(4):733-740. doi: 10.1007/s00192-024-06007-8. Epub 2024 Dec 14.
The objective was to evaluate and compare the short-term postoperative complications of concomitant pelvic organ prolapse (POP) and rectal prolapse repair with isolated apical prolapse repair or rectopexy.
This systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. A comprehensive literature search was performed using Web of Science, PubMed, Embase, and Scopus for studies published up to April 2024. Studies included were retrospective case-control studies, clinical cohort studies, and randomized clinical trials comparing short-term complications between concomitant apical and rectal prolapse repairs versus isolated repairs.
A total of seven studies, encompassing 16,471 patients, met the inclusion criteria. Of these, 843 patients underwent concomitant surgery, 7,808 underwent apical prolapse repair alone, and 7,820 underwent rectopexy alone. The meta-analysis revealed no significant increase in the overall complication rate for the concomitant group compared with the apical prolapse alone (OR 0.78; 95% CI 0.56, 1.09; p = 0.14; I = 0%) or rectopexy alone (OR 0.79; 95% CI 0.49, 1.25; p = 0.31; I = 48%). Furthermore, serious complication rates were not significantly higher in the concomitant group compared with isolated apical prolapse repair (OR 0.70; 95% CI 0.43, 1.16; p = 0.16; I = 0%) or rectopexy alone (OR 0.86; 95% CI 0.54, 1.35; p = 0.50; I = 39%).
Concomitant apical and rectal prolapse repair does not significantly increase the risk of short-term postoperative complications compared with isolated repairs. This approach appears safe and feasible, suggesting that combined surgeries might offer a comprehensive treatment for patients with multicompartmental prolapse without elevating operative risks.
目的是评估并比较盆腔器官脱垂（POP）与直肠脱垂联合修复术与单纯顶端脱垂修复术或直肠固定术的术后短期并发症。
本系统评价和荟萃分析按照PRISMA指南进行。使用Web of Science、PubMed、Embase和Scopus对截至2024年4月发表的研究进行全面文献检索。纳入的研究为回顾性病例对照研究、临床队列研究以及比较顶端与直肠联合脱垂修复术和单纯修复术短期并发症的随机临床试验。
共有7项研究符合纳入标准，涉及16471例患者。其中，843例患者接受了联合手术，7808例仅接受顶端脱垂修复术，7820例仅接受直肠固定术。荟萃分析显示，与单纯顶端脱垂修复术（比值比[OR]0.78；95%置信区间[CI]0.56，1.09；p = 0.14；I² = 0%）或单纯直肠固定术（OR 0.79；95% CI 0.49，1.25；p = 0.31；I² = 48%）相比，联合手术组的总体并发症发生率没有显著增加。此外，与单纯顶端脱垂修复术（OR 0.70；95% CI 0.43，1.16；p = 0.16；I² = 0%）或单纯直肠固定术（OR 0.86；95% CI 0.54，1.35；p = 0.50；I² = 39%）相比，联合手术组的严重并发症发生率也没有显著更高。
与单纯修复术相比，顶端与直肠联合脱垂修复术不会显著增加术后短期并发症的风险。这种方法似乎安全可行，表明联合手术可能为多部位脱垂患者提供一种综合治疗方法，而不会增加手术风险。
