Shang Yingying, Deng Huajuan, Yao Qingqing
Department of Gynaecology, Xi'an International Medical Center Hospital, Xi'an, China.
Department of Gynaecology and Obstetrics, Hanjiang Hospital Affiliated to Xi 'an Medical College, Xi'an, Hanzhong, China.
Technol Health Care. 2025 May;33(3):1381-1388. doi: 10.1177/09287329241296231. Epub 2024 Dec 9.
BackgroundPelvic organ prolapse is a prevalent condition affecting women of varying ages and ethnicities globally. The prevalence of pelvic organ prolapse is substantial, with estimates suggesting that up to 50% of parous women may experience some degree of prolapse during their lifetime.ObjectiveThis retrospective evaluation aimed to compare the outcomes of robot-assisted sacral colpopexy (RASC) and traditional laparoscopic sacral colpopexy (LSC) in the treatment of pelvic organ prolapse, focusing on surgical outcomes, postoperative pain, quality of life, complications, and recurrence rates.MethodsA total of 138 patients treated for pelvic organ prolapse and undergoing sacral colpopexy from December 2021 to December 2023 were included in the study. The patients were categorized into two groups based on the procedure utilized: RASC or LSC. Demographic characteristics, surgical outcomes, postoperative pain scores, quality of life, complications, and recurrence rates were compared between the two groups.ResultsThe demographic characteristics of the study population demonstrated comparable baseline profiles for the RASC and LSC groups. RASC was associated with shorter surgery duration, lower intraoperative blood loss, shorter operative time for apical prolapse repair, and significantly lower postoperative pain scores at 24, 48, and 72 h postoperatively compared to LSC. Additionally, patients undergoing RASC demonstrated significantly better quality of life across various domains compared to those undergoing LSC. There were no statistically significant differences in the incidence of complications between the two groups. Furthermore, the RASC group demonstrated consistently lower recurrence rates at 1, 2, and 5 years postoperatively compared to the LSC group.ConclusionRobot-assisted sacral colpopexy offers potential advantages over traditional laparoscopic sacral colpopexy in the treatment of pelvic organ prolapse, with favorable surgical outcomes, reduced postoperative pain, improved quality of life, comparable complication rates, and lower recurrence rates. These findings support the consideration of RASC as a promising surgical approach for addressing pelvic organ prolapse and provide valuable insights for informing clinical decision-making and refining the approach to pelvic organ prolapse treatment.
背景
盆腔器官脱垂是一种普遍存在的疾病，影响着全球不同年龄和种族的女性。盆腔器官脱垂的患病率很高，据估计，高达50%的经产妇在其一生中可能会经历某种程度的脱垂。
目的
本回顾性评估旨在比较机器人辅助骶骨阴道固定术（RASC）和传统腹腔镜骶骨阴道固定术（LSC）在治疗盆腔器官脱垂方面的效果，重点关注手术结果、术后疼痛、生活质量、并发症和复发率。
方法
本研究纳入了2021年12月至2023年12月期间接受盆腔器官脱垂治疗并进行骶骨阴道固定术的138例患者。根据所采用的手术方法将患者分为两组：RASC组或LSC组。比较两组患者的人口统计学特征、手术结果、术后疼痛评分、生活质量、并发症和复发率。
结果
研究人群中的人口统计学特征表明，RASC组和LSC组的基线特征具有可比性。与LSC相比，RASC的手术时间更短，术中出血量更少，顶端脱垂修复的手术时间更短，术后24、48和72小时的术后疼痛评分显著更低。此外，与接受LSC的患者相比，接受RASC的患者在各个领域的生活质量明显更好。两组之间并发症的发生率没有统计学上的显著差异。此外，与LSC组相比，RASC组在术后1、2和5年的复发率持续较低。
结论
在治疗盆腔器官脱垂方面，机器人辅助骶骨阴道固定术相对于传统腹腔镜骶骨阴道固定术具有潜在优势，手术效果良好，术后疼痛减轻，生活质量提高，并发症发生率相当，复发率更低。这些发现支持将RASC视为治疗盆腔器官脱垂的一种有前景的手术方法，并为临床决策和改进盆腔器官脱垂治疗方法提供了有价值的见解。
