Concomitant apical suspensory procedures in women with anterior vaginal wall prolapse in the United States in 2011
Concomitant apical suspensory procedures in women with anterior vaginal wall prolapse in the United States in 2011
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DOI：
10.1007/s00192-015-2894-3
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发表时间：
2016-04
影响因子：
1.8
通讯作者：
G. Northington;C. Hudson;Deborah R. Karp;S. Huber
中科院分区：
文献类型：
--
作者：
G. Northington;C. Hudson;Deborah R. Karp;S. Huber
虽然手术修复根尖支持已被证明可以降低再手术率，但目前尚不清楚这是否已被纳入当前的实践。本研究的目的是要确定在2011年进行手术repair.MethodsThis横断面研究查询全国住院患者样本的妇女与膀胱膨出谁在2011年接受脱垂修复的初步诊断，同时顶端悬吊程序的妇女率。分析研究队列的人口统计学、伴随手术和医院特征。确定根尖悬吊术的发生率。使用单变量分析和多变量logistic regression.ResultsA数据库中共有2，900名女性在2011年进行了膀胱膨出的初步诊断和手术脱垂修复，与接受同期心尖悬吊术的潜在相关因素进行了评估。925例（31.9%）受试者同时接受心尖悬吊术。研究队列的平均年龄为61.9 ± 12.8岁。11.1%的受试者进行了子宫切除术。61.1经阴道、腹腔镜和腹腔镜分别占26.5%和12.5%。多变量分析显示，年龄大于50岁、白人、同时行子宫切除术和城市教学医院环境与2011年接受同时行心尖悬吊术独立相关。结论尽管有证据表明心尖支撑的恢复对最佳前路支撑很重要，但同时行心尖悬吊术的总体比率较低。有几个因素可能会影响女性是否接受心尖悬吊术。这项研究强调了提高阴道前脱垂妇女手术护理质量的机会。
IntroductionAlthough the surgical restoration of apical support has been shown to decrease reoperation rates, it is unclear whether this has been incorporated into current practice. The aims of this study were to determine the rate of concomitant apical suspensory procedures in women with anterior vaginal wall prolapse undergoing surgical repair in 2011 and to identify associated factors.MethodsThis cross-sectional study queried the Nationwide Inpatient Sample for women with a primary diagnosis of cystocele who underwent prolapse repair in 2011. The study cohort was analyzed for demographics, concomitant procedures, and hospital characteristics. The rate of apical suspensory procedures was determined. Factors potentially associated with receiving concomitant apical suspensory procedure were evaluated using univariate analysis and multivariate logistic regression.ResultsA total of 2,900 women in the database had a primary diagnosis of cystocele and underwent surgical prolapse repair in 2011. 925 (31.9 %) subjects underwent a concomitant apical suspensory procedure. The mean age in the study cohort was 61.9 ± 12.8 years. Hysterectomies were performed in 11.1 % of subjects. 61.1 % were performed vaginally, 26.5 % laparoscopically, and 12.5 % abdominally. On multivariate analysis, age greater than 50 years, Caucasian race, concomitant hysterectomy, and an urban teaching hospital setting were independently associated with receiving concomitant apical suspensory procedure in 2011.ConclusionsDespite evidence that the restoration of apical support is important for optimal anterior support, the overall rate of concomitant apical suspensory procedures is low. Several factors may play a role in whether or not women receive an apical suspensory procedure. This study highlights opportunities to improve the quality of surgical care provided to women with anterior vaginal prolapse.