Parsaei Mohammadamin, Hadizadeh Alireza, Hadizadeh Shiva, Tarafdari Azadeh
Breastfeeding Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran (Dr Parsaei).
Department of Obstetrics and Gynecology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran (Drs A. Hadizadeh, S. Hadizadeh and Tarafdari).
J Minim Invasive Gynecol. 2025 Feb 28. doi: 10.1016/j.jmig.2025.02.014.
To assess and compare the efficacy of laparoscopic pectopexy and laparoscopic sacrocolpopexy in managing pelvic organ prolapse.
A systematic search of PubMed, Web of Science, Scopus, and Embase was conducted on July 3, 2024, using the search terms "Pectopexy" AND "Laparoscop*" with no publication date restrictions. Additional sources included citation screening and searches in Google Scholar and ProQuest.
We included all peer-reviewed, English full-text articles comparing intraoperative, short-term (up to 6 months), or long-term (6 to 12 months) outcomes for laparoscopic pectopexy and sacrocolpopexy in pelvic organ prolapse management.
TABULATION, INTEGRATION, AND RESULTS: Our electronic search identified 269 records, of which 11 were deemed eligible after thorough screening. No additional eligible articles were found through a manual search. The final review included 11 studies, comprising 1043 patients across 4 randomized controlled trials, 6 retrospective studies, and one prospective cohort. Meta-analyses using a random-effects model showed lower operation time (Hedges's g = -0.978 [-1.629, -0.327]; p = .003) and blood loss (Hedges's g = -0.658 [-1.160, -0.155]; p = .010) in pectopexy, with comparable organ injury rates (p > .05) between procedures. Short-term results showed a shorter hospitalization duration for pectopexy (Hedges's g = -0.213 [-0.426, -0.000]; p = .049), while post-surgery outcomes like urinary tract infection, and voiding dysfunction were similar across groups (p > .05). All long-term outcomes were comparable, including apical prolapse recurrence, mesh-related complications, pelvic organ prolapse quantification system scores, constipation, urgency, stress urinary incontinence, dyspareunia, and patient satisfaction (p > .05).
This review highlights that laparoscopic pectopexy, despite its theoretical technical advantages, shows comparable intraoperative organ injury rates and similar urinary, defecation, and sexual function outcomes to laparoscopic sacrocolpopexy. However, pectopexy is linked to shorter operative times, less blood loss, and reduced post-operative hospitalization.
评估和比较腹腔镜耻骨后固定术和腹腔镜骶骨阴道固定术治疗盆腔器官脱垂的疗效。
于2024年7月3日对PubMed、科学网、Scopus和Embase进行系统检索，检索词为“耻骨后固定术”和“腹腔镜*”，无出版日期限制。其他来源包括引文筛选以及在谷歌学术和ProQuest中进行的检索。
我们纳入了所有经同行评审的英文全文文章，这些文章比较了腹腔镜耻骨后固定术和骶骨阴道固定术在盆腔器官脱垂治疗中的术中、短期（最长6个月）或长期（6至12个月）结果。
制表、整合与结果：我们的电子检索识别出269条记录，经过全面筛选后，其中11条被认为符合条件。通过手动检索未发现其他符合条件的文章。最终综述纳入了11项研究，包括4项随机对照试验、6项回顾性研究和1项前瞻性队列研究中的1043例患者。采用随机效应模型的荟萃分析显示，耻骨后固定术的手术时间较短（Hedges's g = -0.978 [-1.629, -0.327]；p = .003），失血量较少（Hedges's g = -0.658 [-1.160, -0.155]；p = .010），两种手术的器官损伤率相当（p > .05）。短期结果显示耻骨后固定术的住院时间较短（Hedges's g = -0.213 [-0.426, -0.000]；p = .049），而各组术后的尿路感染和排尿功能障碍等结果相似（p > .05）。所有长期结果相当，包括顶端脱垂复发、网片相关并发症、盆腔器官脱垂量化系统评分、便秘、尿急、压力性尿失禁、性交困难和患者满意度（p > .05）。
本综述强调，腹腔镜耻骨后固定术尽管在理论技术上具有优势，但与腹腔镜骶骨阴道固定术相比，术中器官损伤率相当，泌尿、排便和性功能结果相似。然而，耻骨后固定术的手术时间较短，失血量较少，术后住院时间缩短。
