Is absorbable suture superior to permanent suture for uterosacral ligament suspension?
Is absorbable suture superior to permanent suture for uterosacral ligament suspension?
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子宫骶韧带悬吊时可吸收缝合线是否优于永久缝合线？
DOI：
10.1002/nau.24434
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发表时间：
2020-07-13
影响因子：
2
通讯作者：
Luo, De-yi
中科院分区：
文献类型：
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作者：
Peng, Liao;Liu, Yu-hao;Luo, De-yi
目的 本研究的目的是比较可吸收缝合线 (AS) 与永久缝合线 (PS) 子宫骶韧带悬吊 (USLS) 后的手术结果和缝合相关并发症。方法 我们系统地检索了 PubMed、Embase、Cochrane 图书馆对照试验中央注册库，以查找比较 AS 与 PS 进行 USLS 的文章。主要结局是手术成功率和缝合相关并发症（缝线暴露/侵蚀和缝线拆除）。 Review Manager 5.3（Cochrane Collaboration，牛津，英国）用于进行所有分析。结果最终纳入4篇文章，涉及647名患者。我们的研究结果表明，与 PS 相比，AS 的手术成功率相似（RR = 1.00；95% CI，0.94-1.06），并且两组之间的解剖失败率没有显着差异（RR = 1.10；95% CI，0.65-1.86）。解剖学失败的亚组分析显示，心尖脱垂 >= 1/2 TVL（RR = 0.92；95% CI，0.48-1.75）、处女膜外复发性脱垂（RR = 1.18；95% CI，0.68-2.04）以及复发性前、后或心尖脱垂（P = 0.14，P = .08，P = .09，分别）。然而，AS 组的缝线暴露/侵蚀风险较低（RR = 0.31；95% CI，0.15-0.63），缝线拆除率较低（RR = 0.35；95% CI，0.18-0.67）。结论 由于相似的手术结果、更少的缝线暴露/侵蚀以及更少的缝线去除，目前的数据支持 AS 与 PS 一样有效，但具有更好的安全性。
Aims The aims of this study were to compare surgical results and suture-related complications after uterosacral ligament suspension (USLS) with absorbable suture (AS) vs permanent suture (PS). Methods We systematically searched PubMed, Embase, , and Cochrane Library Central Register of Controlled Trials for articles that compared AS with PS for USLS. The primary outcomes were surgical success rate and suture-related complications (suture exposure/erosion and suture removal). Review Manager 5.3 (Cochrane Collaboration, Oxford, UK) was applied to conduct all analyses. Results Four articles involving 647 patients were eventually included. Our findings demonstrated that AS had a similar surgical success rates in comparison with PS (RR = 1.00; 95% CI, 0.94-1.06) and that no significant differences in anatomic failure rates were noted between two groups (RR = 1.10; 95% CI, 0.65-1.86). Subgroup analyses in anatomic failure revealed no statistical differences in apical prolapse >= 1/2 TVL (RR = 0.92; 95% CI, 0.48-1.75), recurrent prolapse beyond the hymen (RR = 1.18; 95% CI, 0.68-2.04), as well as in recurrent anterior, posterior or apical prolapse (P = .14,P = .08,P = .09, respectively). However, AS group indicated a lower risk in suture exposure/erosion (RR = 0.31; 95% CI, 0.15-0.63) and lower suture removal rate (RR = 0.35; 95% CI, 0.18-0.67). Conclusions Due to similar surgical results, less suture exposure/erosion and less suture removal, the current data supported that AS is as effective as PS, but with a better safety profile.