Initial Experience of Laparoscopic Pectopexy for Apical Prolapse in South Korea
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초록
Pelvic organ prolapse (POP) is the herniation or bulging of the pelvic organs to or beyond the vaginal introitus. POP is a common condition affecting more than half of parous women. We recently performed POP surgery and repair in 37 patients using laparoscopic pectopexy, a new technique for apical prolapse surgery, in women with advanced POP. The surgery was performed by a single surgeon at a single institute. The methods of operation were divided into total laparoscopic hysterectomy with pectopexy, supracervical hysterectomy with pectopexy or pectopexy alone, with additional anterior or posterior colporrhaphy selectively performed. All patients were analyzed in terms of age, body mass index, parity, estimated blood loss (EBL), operation time, intraoperative complications, and postoperative complications. The patients were followed up for at least 6 months after surgery, and the short-term clinical outcomes were analyzed. All operations were performed successfully and without severe intraoperative or postoperative complications. The mean EBL was 84 mL, and the mean operation time was 121 minutes. The operation satisfaction rates were high in most patients. All patients had no recurrence of apical prolapse, de novo urgency, frequency, incontinence, de novo constipation, or ileus. In our experience, laparoscopic pectopexy is a feasible method for apical prolapse repair as it does not have severe intraoperative or postoperative complications and de novo gastrointestinal complications. Considerable follow-up period for possible postoperative events is warranted.
Abstract
Pelvic organ prolapse (POP) is the herniation or bulging of the pelvic organs to or beyond the vaginal introitus. POP is a common condition affecting more than half of parous women. We recently performed POP surgery and repair in 37 patients using laparoscopic pectopexy, a new technique for apical prolapse surgery, in women with advanced POP. The surgery was performed by a single surgeon at a single institute. The methods of operation were divided into total laparoscopic hysterectomy with pectopexy, supracervical hysterectomy with pectopexy or pectopexy alone, with additional anterior or posterior colporrhaphy selectively performed. All patients were analyzed in terms of age, body mass index, parity, estimated blood loss (EBL), operation time, intraoperative complications, and postoperative complications. The patients were followed up for at least 6 months after surgery, and the short-term clinical outcomes were analyzed. All operations were performed successfully and without severe intraoperative or postoperative complications. The mean EBL was 84 mL, and the mean operation time was 121 minutes. The operation satisfaction rates were high in most patients. All patients had no recurrence of apical prolapse, de novo urgency, frequency, incontinence, de novo constipation, or ileus. In our experience, laparoscopic pectopexy is a feasible method for apical prolapse repair as it does not have severe intraoperative or postoperative complications and de novo gastrointestinal complications. Considerable follow-up period for possible postoperative events is warranted.
참고문헌 (15)
- Barber MD, "Epidemiology and outcome assessment of pelvic organ prolapse", Int Urogynecol J, 24, pp.1783~1790 (2013)
- American Urogynecologic Society, "Pelvic organ prolapse", Female Pelvic Med Reconstr Surg, 25, pp.397~408 (2019)
- Yuk JS, "The prevalence and treatment pattern of clinically diagnosed pelvic organ prolapse: a Korean National Health Insurance Database-based cross-sectional study 2009-2015", Sci Rep, 8, pp.1334~ (2018)
- Dällenbach P, "To mesh or not to mesh : a review of pelvic organ reconstructive surgery", Int J Womens Health, 7, pp.331~343 (2015)
- Giannini A, "Current management of pelvic organ prolapse in aging women : EMAS clinical guide", Maturitas, 110, pp.118~123 (2018)
- Madhu CK, "Surgery for pelvic organ prolapse", Eur Urol Suppl, 17, pp.119~125 (2018)
- Nygaard IE, "Abdominal sacrocolpopexy : a comprehensive review", Obstet Gynecol, 104, pp.805~823 (2004)
- Sarlos D, "Laparoscopic sacrocolpopexy for uterine and post-hysterectomy prolapse : anatomical results, quality of life and perioperative outcome-a prospective study with 101 cases", Int Urogynecol J Pelvic Floor Dysfunct, 19, pp.1415~1422 (2008)
- Whitehead WE, "Gastrointestinal complications following abdominal sacrocolpopexy for advanced pelvic organ prolapse", Am J Obstet Gynecol, 197, pp.78~ (2007)
- Banerjee C, "Laparoscopic pectopexy : a new technique of prolapse surgery for obese patients", Arch Gynecol Obstet, 284, pp.631~635 (2011)
- Noé KG, "Laparoscopic pectopexy: a randomised comparative clinical trial of standard laparoscopic sacral colpo-cervicopexy to the new laparoscopic pectopexy. Short-term postoperative results", Arch Gynecol Obstet, 287, pp.275~280 (2013)
- Noé GK, "Prospective international multicenter pectopexy trial : Interim results and findings post surgery", Eur J Obstet Gynecol Reprod Biol, 244, pp.81~86 (2020)
- Biler A, "Perioperative complications and short-term outcomes of abdominal sacrocolpopexy, laparoscopic sacrocolpopexy, and laparoscopic pectopexy for apical prolapse", Int Braz J Urol, 44, pp.996~1004 (2018)
- Mairesse S, "Complications and reoperation after pelvic organ prolapse, impact of hysterectomy, surgical approach and surgeon experience", Int Urogynecol J, 31, pp.1755~1761 (2020)
- Dallas K, "Association between concomitant hysterectomy and repeat surgery for pelvic organ prolapse repair in a cohort of nearly 100, 000 women", Obstet Gynecol, 132, pp.1328~1336 (2018)