Comparison of laparoscopic sacrocolpopexy with vaginal reconstructive procedures and abdominal sacrocolpopexy for the surgical management of vaginal vault prolapse: a systematic review and meta-analysis.

Autor: Ciortea R; Mother and Child Department, 'Iuliu Hațieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania.; 2nd Obstetrics and Gynaecology Clinical Section, Cluj County Emergency Clinical Hospital, Cluj-Napoca, Romania., Roman MP; Mother and Child Department, 'Iuliu Hațieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania.; 2nd Obstetrics and Gynaecology Clinical Section, Cluj County Emergency Clinical Hospital, Cluj-Napoca, Romania., Măluțan AM; Mother and Child Department, 'Iuliu Hațieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania.; 2nd Obstetrics and Gynaecology Clinical Section, Cluj County Emergency Clinical Hospital, Cluj-Napoca, Romania., Bucuri CE; Mother and Child Department, 'Iuliu Hațieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania.; Military Emergency Hospital 'Dr. Constantin Papilian', Cluj-Napoca, Romania., Ormindean CM; Mother and Child Department, 'Iuliu Hațieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania.; 2nd Obstetrics and Gynaecology Clinical Section, Cluj County Emergency Clinical Hospital, Cluj-Napoca, Romania., Nati ID; Mother and Child Department, 'Iuliu Hațieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania.; 2nd Obstetrics and Gynaecology Clinical Section, Cluj County Emergency Clinical Hospital, Cluj-Napoca, Romania., Mihu D; Mother and Child Department, 'Iuliu Hațieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania.; 2nd Obstetrics and Gynaecology Clinical Section, Cluj County Emergency Clinical Hospital, Cluj-Napoca, Romania.
Jazyk: angličtina
Zdroj: Frontiers in medicine [Front Med (Lausanne)] 2023 Sep 12; Vol. 10, pp. 1269214. Date of Electronic Publication: 2023 Sep 12 (Print Publication: 2023).
DOI: 10.3389/fmed.2023.1269214
Abstrakt: Introduction: Vaginal vault prolapse, also known as apical prolapse, is a distressing condition that may affect women following hysterectomy, necessitating surgical intervention when conservative measures prove ineffective. The surgical management of apical compartment prolapse includes procedures such as laparoscopic sacrocolpopexy (LSCP), abdominal sacrocolpopexy (ASCP) or vaginal reconstructive procedures (VRP). This systematic review and meta-analysis aims to compare the outcomes of these interventions.
Methods: A comprehensive search of electronic databases was conducted to identify eligible studies. Fourteen studies comprising a total of 1,289 women were included. The selected studies were analyzed to evaluate outcomes such as duration of surgery, length of hospital stay, blood loss, complication rates, and patient satisfaction.
Results: LSCP did not demonstrate significant advantages over VRP in terms of perioperative or long-term outcomes. However, when compared to ASCP, LSCP showed shorter hospital stay, reduced blood loss, decreased postoperative pain, and lower rates of ileus.
Discussion: This systematic review contributes to evidence-based decision-making for the surgical treatment of vaginal vault prolapse. While LSCP did not exhibit substantial benefits over VRP, it emerged as a preferable option compared to ASCP due to shorter hospital stays and reduced postoperative complications. The findings from this study provide valuable insights for clinicians and patients in selecting the most appropriate surgical approach for vaginal vault prolapse. However, future research should focus on long-term follow-ups, standardizing outcomes, and outcome measures, and evaluating cost-effectiveness to further enhance clinical practice.
Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
(Copyright © 2023 Ciortea, Roman, Măluțan, Bucuri, Ormindean, Nati and Mihu.)
Databáze: MEDLINE