Surgical Outcomes and Safety of Robotic Sacrocolpopexy in Women With Apical Pelvic Organ Prolapse
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Purpose: This study aimed to investigate the surgical outcomes and safety of robotic sacrocolpopexy (RSC) in patients with uterine/vaginal vault prolapse. Methods: Between January 2009 and June 2015, 16 women with apical prolapse underwent RSC. Pelvic organ prolapse quantification (POP-Q) examination was performed, and treatment success was defined as the presence of grade 0 or I apical prolapse upon POP-Q examination at the final follow-up. Pelvic floor distress inventory-short form 20 (PFDI-SF 20) was administered at every follow-up. A treatment satisfaction questionnaire was administered by telephone to evaluate patient satisfaction with the operation. Results: Median age was 65 years (interquartile range [IQR], 56–68 years), and follow-up duration was 25.3 months (IQR, 5.4–34.0 months). Thirteen women (81.3%) had ≥grade III apical prolapse. Operation time was 251 minutes (IQR, 236–288 minutes), and blood loss was 75 mL (IQR, 50–150 mL). Median hospital stay was 4 days (IQR, 3–5 days). At the final followup, treatment success was reported in all patients, who presented grade 0 (n=8, 57.1%) and grade I (n=6, 42.9%) apical prolapse. Dramatic improvements in PFDI-SF 20 scores were noted after RSC (from 39 to 4; P=0.001). Most patients (12 of 13) were satisfied with RSC. An intraoperative complication (sacral venous plexus injury) was reported in 1 patient, and there was no conversion to open surgery. Mesh erosion was not reported. Conclusions: RSC is an efficient and safe surgical option for apical prolapse repair. Most patients were satisfied with RSC. Thus, RSC might be one of the best treatment options for apical prolapse in women.
Abstract
Purpose: This study aimed to investigate the surgical outcomes and safety of robotic sacrocolpopexy (RSC) in patients with uterine/vaginal vault prolapse. Methods: Between January 2009 and June 2015, 16 women with apical prolapse underwent RSC. Pelvic organ prolapse quantification (POP-Q) examination was performed, and treatment success was defined as the presence of grade 0 or I apical prolapse upon POP-Q examination at the final follow-up. Pelvic floor distress inventory-short form 20 (PFDI-SF 20) was administered at every follow-up. A treatment satisfaction questionnaire was administered by telephone to evaluate patient satisfaction with the operation. Results: Median age was 65 years (interquartile range [IQR], 56–68 years), and follow-up duration was 25.3 months (IQR, 5.4–34.0 months). Thirteen women (81.3%) had ≥grade III apical prolapse. Operation time was 251 minutes (IQR, 236–288 minutes), and blood loss was 75 mL (IQR, 50–150 mL). Median hospital stay was 4 days (IQR, 3–5 days). At the final followup, treatment success was reported in all patients, who presented grade 0 (n=8, 57.1%) and grade I (n=6, 42.9%) apical prolapse. Dramatic improvements in PFDI-SF 20 scores were noted after RSC (from 39 to 4; P=0.001). Most patients (12 of 13) were satisfied with RSC. An intraoperative complication (sacral venous plexus injury) was reported in 1 patient, and there was no conversion to open surgery. Mesh erosion was not reported. Conclusions: RSC is an efficient and safe surgical option for apical prolapse repair. Most patients were satisfied with RSC. Thus, RSC might be one of the best treatment options for apical prolapse in women.
참고문헌 (30)
- Wu JM, "Lifetime risk of stress urinary incontinence or pelvic organ prolapse surgery", Obstet Gynecol, 123, pp.1201~1206 (2014)
- Samuelsson EC, "Signs of genital prolapse in a Swedish population of women 20 to 59 years of age and possible related factors", Am J Obstet Gynecol, 180(2Pt 1), pp.299~305 (1999)
- Nygaard I, "Prevalence of symptomatic pelvic floor disorders in US women", JAMA, 300, pp.1311~1316 (2008)
- Wu JM, "Forecasting the prevalence of pelvic floor disorders in U.S. Women: 2010 to 2050", Obstet Gynecol, 114, pp.1278~1283 (2009)
- Subak LL, "Cost of pelvic organ prolapse surgery in the United States", Obstet Gynecol, 98, pp.646~651 (2001)
- Svihrova V, "Disability-adjusted life years(DALYs)in general population with pelvic organ prolapse : a study based on the prolapse quality-of-life questionnaire(P-QOL)", Eur J Obstet Gynecol Reprod Biol, 182, pp.22~26 (2014)
- Lane FE, "Repair of posthysterectomy vaginal-vault prolapse", Obstet Gynecol, 20, pp.72~77 (1962)
- Maher C, "Surgical management of pelvic organ prolapse in women", Cochrane Database Syst Rev, (4), pp.CD004014~ (2013)
- 최경화, "Management of Pelvic Organ Prolapse", Investigative and Clinical Urology, 55(11), pp.693~702 (2014), 대한비뇨기과학회
- Ganatra AM, "The current status of laparoscopic sacrocolpopexy : a review", Eur Urol, 55, pp.1089~1103 (2009)
- Nezhat CH, "Laparoscopic sacral colpopexy for vaginal vault prolapse", Obstet Gynecol, 84, pp.885~888 (1994)
- Paraiso MF, "Laparoscopic and abdominal sacral colpopexies : a comparative cohort study", Am J Obstet Gynecol, 192, pp.1752~1758 (2005)
- Tarr ME, "Comparison of postural ergonomics between laparoscopic and robotic sacrocolpopexy : a pilot study", J Minim Invasive Gynecol, 22, pp.234~238 (2015)
- Di Marco DS, "Robotic-assisted laparoscopic sacrocolpopexy for treatment of vaginal vault prolapse", Urology, 63, pp.373~376 (2004)
- Sajadi KP, "Robotic pelvic organ prolapse surgery", Nat Rev Urol, 12, pp.216~224 (2015)
- Serati M, "Robot-assisted sacrocolpopexy for pelvic organ prolapse : a systematic review and meta-analysis of comparative studies", Eur Urol, 66, pp.303~318 (2014)
- Anger JT, "Robotic compared with laparoscopic sacrocolpopexy : a randomized controlled trial", Obstet Gynecol, 123, pp.5~12 (2014)
- 전명재, "A Long-Term Treatment Outcome of Abdominal Sacrocolpopexy", Yonsei Medical Journal, 50(6), pp.807~813 (2009), 연세대학교의과대학
- 오수민, "Perioperative and postoperative morbidity after sacrocolpopexy according to age in Korean women", Obstetrics & Gynecology Science, 58(1), pp.59~64 (2015), 대한산부인과학회[DOI]
- Sung HH, "Recent advances in robotic surgery in female urology", Int J Urol, 20, pp.1154~1162 (2013)
- 유은희, "Translation and linguistic validation of Korean version of short form of pelvic floor distress inventory-20, pelvic floor impact questionnaire-7", Obstetrics & Gynecology Science, 56(05), pp.330~332 (2013), 대한산부인과학회[DOI]
- Paraiso MF, "Laparo scopic compared with robotic sacrocolpopexy for vaginal prolapse : a randomized controlled trial", Obstet Gynecol, 118, pp.1005~1013 (2011)
- Merseburger AS, "EAU guidelines on robotic and single-site surgery in urology", Eur Urol, 64, pp.277~291 (2013)
- "Urogynecologic surgical mesh: update on the safety and effectiveness of transvaginal placement for pelvic organ prolapse" (2011)[URL]
- Haylen BT, "An International Urogynecological Association (IUGA)", International Continence Society (ICS) joint terminology and classification of the complications related directly to the insertion of prostheses (meshes, implants, tapes) & grafts in female pelvic floor surgery, 2011, pp.22, 3~15
- LeClaire EL, "Is de novo stress incontinence after sacrocolpopexy related to anatomical changes and surgical approach?", Int Urogynecol J, 25, pp.1201~1206 (2014)
- El Hamamsy D, "New onset stress urinary incontinence following laparoscopic sacrocolpopexy and its relation to anatomical outcomes", Int Urogynecol J, 26, pp.1041~1045 (2015)
- Gutman R, "Uterine-preserving POP surgery", Int Urogynecol J, 24, pp.1803~1813 (2013)
- Bogani G, "Risk of undiagnosed uterine malignancies at the time of robotic supracervical hysterectomy and sacrocolpopexy", Eur Urol, 67, pp.352~ (2015)
- Frick AC, "Risk of unanticipated abnormal gynecologic pathology at the time of hysterectomy for uterovaginal prolapse", Am J Obstet Gynecol, 202, pp.507.e1~507.e4 (2010)