Comparison of the effectiveness of sacrospinous ligament fixation and sacrocolpopexy: a meta-analysis
| Autor: | Xiaozhong Wang, Willy Cecilia Cheon, Li Zhang, Wenju Zhang, Yuzhen Wei, Chaoxia Lyu |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Urology Cochrane Library Pelvic Organ Prolapse law.invention Gynecologic Surgical Procedures Randomized controlled trial law medicine.ligament Medicine Humans Prospective Studies Prospective cohort study Fixation (histology) Retrospective Studies Ligaments business.industry Sacrospinous ligament Obstetrics and Gynecology Retrospective cohort study Surgery Treatment Outcome Meta-analysis Female business Sexual function |
| Zdroj: | International urogynecology journal. 33(1) |
| ISSN: | 1433-3023 |
| Popis: | Introduction and hypothesis Sacrocolpopexy and sacrospinous ligament fixation (SSLF) have been used for the restoration of apical support. Studies comparing sacrocolpopexy and SSLF have reported conflicting results. We aim to assess the current evidence regarding efficiency and the complications of sacrocolpopexy compared with SSLF. Methods We searched PubMed, Embase, and Cochrane Library and performed a systematic review meta-analysis to assess the two surgical approaches. Results 5Five randomized controlled trials, 8 retrospective studies, and 2 prospective studies including 4,120 cases were identified. Compared with abdominal sacrocolpopexy (ASC), SSLF was associated with a lower success rate (88.32% and 91.45%; OR 0.52; 95% CI 0.29–0.95; p = 0.03), higher recurrence (11.58% and 8.32%; OR 1.97; 95% CI 1.04–3.46; p = 0.04), and dyspareunia rate (14.36% and 4.67%; OR 3.10; 95% CI 1.28–7.50; p = 0.01). Patients in this group may benefit from shorter operative time (weighted mean difference −25.08 min; 95% CI −42.29 to −7.88; p = 0.004), lower hemorrhage rate (0.85% and 2.58%; OR 0.45; 95% CI 0.25–0.85; p = 0.009), wound infection rate (3.30% and 5.76%; OR 0.55; 95% CI 0.39–0.77; p = 0.0005), and fewer gastrointestinal complications (1.33% and 6.19%; OR 0.33; 95% CI 0.15–0.76; p = 0.009). Conclusion Both sacrocolpopexy and SSLF offer an efficient alternative to the restoration of apical support. When anatomical durability and sexual function is a priority, ASC may be the preferred option. When considering factors of mesh erosion, operative time, gastrointestinal complications, hemorrhage, and wound infections, SSLF may be the better option. |
| Databáze: | OpenAIRE |
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