A Study on Laparoscopic Sacral Colpopexy for Uterine Prolapse
0
조회
0
다운로드
0
인용
0
참고문헌
초록
Objectives: We sought to describe the perioperative and postoperative adverse events associated with sacral colpopexy andevaluate the surgical outcome, complications, and benefits of laparoscopic sacral fixation for patients with pelvic prolapse. Methods: Ninety-two women with uterine prolapse underwent sacral colpopexy between January 2011 and September 2016at Chosun University Hospital. Patients’ electronic medical records were investigated for demographic, intraoperative, andpostoperative data. Strict definitions were used for all clinically relevant adverse events. Patients’ outcomes were documented with1 self-administered quality of life questionnaires: the Pelvic Floor Distress Inventory-20 focused on symptom distress. The primaryanalysis looking at perioperative and postoperative adverse events was descriptive and statistics were reported for all groupsas n/N (%) with 95% confidence intervals for categorical variables and as mean ± standard deviation and mean (range) for allcontinuous variables. Results: Their mean age was 69 ± 8.1 years, mean follow-up duration was 12 months, and mean operating time was 61 minutes. There were seven conversions due to anesthetic or surgical difficulties. Follow-up was performed using a telephone questionnaireand physical examination at 12 months. There were three cases of sacral pain with strong analgesics, one of vaginal erosion, twoof transient urinary retentions, one of spondylitis, and two of mesh infection. Of the patients, 98.9% were satisfied with the surgicalresults, while none complained of sexual dysfunction or problems performing her usual activities. Conclusions: Laparoscopic sacral colpopexy is a feasible and highly effective technique that offers good long-term results withcomplication rates similar to those of open surgery with the added benefit of being minimally invasive. (J Menopausal Med 2017;23:190-195)
Abstract
Objectives: We sought to describe the perioperative and postoperative adverse events associated with sacral colpopexy andevaluate the surgical outcome, complications, and benefits of laparoscopic sacral fixation for patients with pelvic prolapse. Methods: Ninety-two women with uterine prolapse underwent sacral colpopexy between January 2011 and September 2016at Chosun University Hospital. Patients’ electronic medical records were investigated for demographic, intraoperative, andpostoperative data. Strict definitions were used for all clinically relevant adverse events. Patients’ outcomes were documented with1 self-administered quality of life questionnaires: the Pelvic Floor Distress Inventory-20 focused on symptom distress. The primaryanalysis looking at perioperative and postoperative adverse events was descriptive and statistics were reported for all groupsas n/N (%) with 95% confidence intervals for categorical variables and as mean ± standard deviation and mean (range) for allcontinuous variables. Results: Their mean age was 69 ± 8.1 years, mean follow-up duration was 12 months, and mean operating time was 61 minutes. There were seven conversions due to anesthetic or surgical difficulties. Follow-up was performed using a telephone questionnaireand physical examination at 12 months. There were three cases of sacral pain with strong analgesics, one of vaginal erosion, twoof transient urinary retentions, one of spondylitis, and two of mesh infection. Of the patients, 98.9% were satisfied with the surgicalresults, while none complained of sexual dysfunction or problems performing her usual activities. Conclusions: Laparoscopic sacral colpopexy is a feasible and highly effective technique that offers good long-term results withcomplication rates similar to those of open surgery with the added benefit of being minimally invasive. (J Menopausal Med 2017;23:190-195)
참고문헌 (21)
- Subak LL, "Cost of pelvic organ prolapse surgery in the United States", Obstet Gynecol, 98, pp.646~651 (2001)
- Olsen AL, "Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence", Obstet Gynecol, 89, pp.501~506 (1997)
- Scali P, "Operations of support-suspension by upper route in the treatment of vaginal prolapse", J Gynecol Obstet Biol Reprod (Paris), 3, pp.365~378 (1974)
- Lefranc JP, "Surgery of genital prolapse using the abdominal approach. Experience of the surgery and gynecology department at the Salpetriere Hospital", J Chir (Paris), 120, pp.431~436 (1983)
- Dorsey JH, "Laparoscopic reconstructive procedures", Obstet Gynecol Forum, 4, pp.2~6 (1993)
- Dorsey JH, "Laparoscopic procedures for incontinence and prolapse", Curr Opin Obstet Gynecol, 6, pp.223~230 (1994)
- Cosson M, "Laparoscopic sacral colpopexy: short-term results and complications in 83 patients", J Gynecol Obstet Biol Reprod (Paris), 29, pp.746~750 (2000)
- Fedele L, "A new laparoscopic procedure for the correction of vaginal vault prolapse", J Urol, 159, pp.1179~1182 (1998)
- Bump RC, "The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction", Am J Obstet Gynecol, 175, pp.10~17 (1996)
- Barber MD, "Psychometric evaluation of 2 comprehensive condition-specific quality of life instruments for women with pelvic floor disorders", Am J Obstet Gynecol, 185, pp.1388~1395 (2001)
- Moore RD, "Colpocleisis and tension-free vaginal tape sling for severe uterine and vaginal prolapse and stress urinary incontinence under local anesthesia", J Am Assoc Gynecol Laparosc, 10, pp.276~280 (2003)
- Culligan PJ, "Long-term success of abdominal sacral colpopexy using synthetic mesh", Am J Obstet Gynecol, 187, pp.1473~1480 (2002)
- Snyder TE, "Abdominal-retroperitoneal sacral colpopexy for the correction of vaginal prolapse", Obstet Gynecol, 77, pp.944~949 (1991)
- Fox SD, "Vault prolapse and rectocele: assessment of repair using sacrocolpopexy with mesh interposition", BJOG, 107, pp.1371~1375 (2000)
- Roovers JP, "A randomised controlled trial comparing abdominal and vaginal prolapse surgery:effects on urogenital function", BJOG, 111, pp.50~56 (2004)
- Shah DK, "Short-term outcome analysis of total pelvic reconstruction with mesh: the vaginal approach", J Urol, 171, pp.261~263 (2004)
- Cosson M, "Mechanical properties of synthetic implants used in the repair of prolapse and urinary incontinence in women: which is the ideal material?", Int Urogynecol J Pelvic Floor Dysfunct, 14, pp.169~178 (2003)
- Deval B, "Surgical treatment of genitourinary prolapse by the abdominal approach. Apropos of a series of 232cases", Ann Chir, 51, pp.256~265 (1997)
- Ben Amna M, "Impact of rectal prolapse and rectocele on TVT results", Prog Urol, 13, pp.453~458 (2003)
- el-Toukhy TA, "The efficacy of laparoscopic mesh colposuspension: results of a prospective controlled study", BJU Int, 88, pp.361~366 (2001)
- Guillonneau B, "Proposal for a, European Scoring System for Laparoscopic Operations in Urology", Eur Urol, 40, pp.2~6 (2001)