Lin Ye, Liu Jun-Jiang, Fang Kun, Wu Han, Li Na
Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Zunyi Medical University, Zunyi 563000 Guizhou Province, China.
Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Zunyi Medical University, Zunyi 563000 Guizhou Province, China.
Eur J Obstet Gynecol Reprod Biol. 2025 Aug;312:114091. doi: 10.1016/j.ejogrb.2025.114091. Epub 2025 Jun 2.
This systematic review and meta-analysis compares clinical outcomes between sacrocolpopexy and pectopexy for the management of pelvic organ prolapse, aiming to provide evidence-based insights to inform clinical decision-making.
Relevant comparative studies were identified through comprehensive searches in PubMed, EMBASE, MEDLINE, the Cochrane Library, and Web of Science databases. Eligible studies included randomized controlled trials, as well as prospective and retrospective cohort studies. Key outcomes assessed were perioperative parameters, anatomical outcomes, recurrence rates, and complication rates. Data analysis was performed using Stata software (Version 18.0).
A total of 10 studies involving 764 patients met the inclusion criteria. Pectopexy demonstrated several advantages over sacrocolpopexy, including significantly shorter operation time (WMD = -34.4 min; 95 % CI = -47.12 to-21.69; p < 0.01), reduced intraoperative blood loss (WMD = -13.34 mL; 95 % CI = -21.37 to-5.32; p < 0.01), and shorter hospital stays (WMD = -0.15 days; 95 % CI = -0.26 to-0.04; p < 0.01). Postoperative bowel dysfunction was less common in the pectopexy group compared to the sacrocolpopexy group (RR = 1.09; 95 % CI = 1.02 to 1.17; p < 0.01). No significant differences were observed between the procedures in terms of postoperative satisfaction rates, recurrence rates, anatomical outcomes, postoperative quality of life, and sexual function scores.
Both pectopexy and sacrocolpopexy are effective and safe procedures for correcting pelvic organ prolapse. However, pectopexy offers advantages such as shorter operative duration, reduced intraoperative blood loss, shorter hospital stays, and reduced incidence of postoperative bowel dysfunction, supporting its use as a viable alternative in clinical practice.
本系统评价和荟萃分析比较了骶骨阴道固定术和耻骨后膀胱尿道悬吊术治疗盆腔器官脱垂的临床结局,旨在提供基于证据的见解,为临床决策提供参考。
通过全面检索PubMed、EMBASE、MEDLINE、Cochrane图书馆和Web of Science数据库,确定相关的比较研究。符合条件的研究包括随机对照试验以及前瞻性和回顾性队列研究。评估的关键结局包括围手术期参数、解剖学结局、复发率和并发症发生率。使用Stata软件(版本18.0)进行数据分析。
共有10项涉及764例患者的研究符合纳入标准。耻骨后膀胱尿道悬吊术相对于骶骨阴道固定术显示出若干优势,包括手术时间显著缩短(加权均数差[WMD]=-34.4分钟;95%置信区间[CI]=-47.12至-21.69;p<0.01)、术中失血量减少(WMD=-13.34毫升;95%CI=-21.37至-5.32;p<0.01)以及住院时间缩短(WMD=-0.15天;95%CI=-0.26至-0.04;p<0.01)。与骶骨阴道固定术组相比,耻骨后膀胱尿道悬吊术组术后肠功能障碍较少见(相对危险度[RR]=1.09;95%CI=1.02至1.17;p<0.01)。在术后满意率、复发率、解剖学结局、术后生活质量和性功能评分方面,两种手术方法之间未观察到显著差异。
耻骨后膀胱尿道悬吊术和骶骨阴道固定术都是矫正盆腔器官脱垂的有效且安全的手术方法。然而,耻骨后膀胱尿道悬吊术具有手术时间较短、术中失血量减少、住院时间缩短以及术后肠功能障碍发生率降低等优势,支持其在临床实践中作为一种可行的替代方法使用。