Short and middle-term outcomes of vaginally assisted laparoscopic sacropolpopexy.

Autor: Aydın S; Department of Obstetric and Gynecology İstanbul, Koc University School of Medicine, Istanbul, Turkey., Ateş S; Department of Obstetric and Gynecology İstanbul, Bezmialem Vakif University, Istanbul, Turkey., Gökmen Karasu AF; Department of Obstetric and Gynecology İstanbul, Bezmialem Vakif University, Istanbul, Turkey., Arıoğlu Ç; Department of Obstetric and Gynecology İstanbul, Medicalpark Hospitals, Istanbul, Turkey.
Jazyk: angličtina
Zdroj: Lower urinary tract symptoms [Low Urin Tract Symptoms] 2021 Apr; Vol. 13 (2), pp. 291-298. Date of Electronic Publication: 2020 Dec 07.
DOI: 10.1111/luts.12369
Abstrakt: Objective: Vaginally assisted laparoscopic sacrocolpopexy (VALS), which is a combined surgical approach where a vaginal hysterectomy is initially performed, followed by transvaginal placement of synthetic mesh and laparoscopic suspension, can be an alternative to overcome the dissection, suturing limitations of laparoscopic sacrocolpopexy. The aim of this study was to compare the operative times and middle-term anatomic outcomes of women with uterovaginal prolapse undergoing VALS with those of women undergoing abdominal sacrocolpopexy.
Methods: This is a prospective cohort study that evaluates operation times, anesthesia times, estimated blood loss, middle-term outcomes, perioperative and postoperative complications. We compared the results of 47 women who had the VALS to that of 32 abdominal sacrocolpopexy (AS).
Results: The mean follow up was 22.4 months for AS group and 20.5 months for VALS group. The VALS group (median 1 day) had shorter hospitalization duration than the AS group (median 3 days). The mean operation time was significantly shorter in the VALS group (125.9 minutes) than the AS group (151.9 minutes) (P = .03). There was no significant difference in perioperative and postoperative complication rates. Objective failure rate (8.5% in VALS, 15.6% in AS), subjective failure rates (6.4% in VALS, 9.4% in AS), recurrence (2.1% in VALS, 9.4% in AS) and mesh exposition rates (2.1% in VALS, 9.4% in AS) were similar in both procedures.
Conclusions: VALS with shorter operative time and hospitalization than conventional AS is a promising modification minimally invasive technique for sacrocolpopexy especially for those inexperienced in laparoscopic sacrocolpopexy.
(© 2020 John Wiley & Sons Australia, Ltd.)
Databáze: MEDLINE
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