Risk factors for mesh/suture erosion following sacral colpopexy
Risk factors for mesh/suture erosion following sacral colpopexy
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DOI：
10.1016/j.ajog.2008.07.029
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发表时间：
2008-01-01
影响因子：
9.8
通讯作者：
Brubaker, Linda
中科院分区：
文献类型：
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作者：
Cundiff, Geoffrey W.;Varner, Edward;Brubaker, Linda
目的：本研究的目的是确定腹部骶骨阴道固定术（ASC）后补片/缝线侵蚀的风险。研究设计：我们分析了骶骨阴道固定术和尿减少研究2年后322名参与者的人口统计学、围手术期变量和侵蚀状态。结果：使用的主要移植物是合成补片：编织聚酯（Mersilene; Ethicon，Inc，萨默维尔，NJ）（42%）或聚丙烯（48%）。20例受试者（6%）发生补片/缝线侵蚀。补片/缝线侵蚀的未校正风险因素为膨胀型聚四氟乙烯（ePTFE）补片（ePTFE 4/21 [19%] vs非ePTFE 16/301 [5%];比值比[OR]，4.2）、同期子宫切除术（OR，4.9）和当前吸烟（OR，5.2）。在补片侵蚀的患者中，大多数受影响的女性（13/17）至少接受了1次手术，以部分或全部取出补片。2例完全解决，6例持续存在问题，5例失访。没有决议记录在4名妇女谁选择observation.CONCLUSION：膨胀PTFE网不应用于骶骨阴道固定术。同时进行子宫切除术和吸烟是补片/缝线侵蚀的可改变风险。
OBJECTIVE: The purpose of this study was to identify risks for mesh/suture erosions following abdominal sacral colpopexy (ASC).STUDY DESIGN: We analyzed demographic, perioperative variables, and erosion status in 322 participants in the Colpopexy and Urinary Reduction Efforts study 2 years after sacral colpopexy.RESULTS: The predominant graft used was synthetic mesh: woven polyester (Mersilene; Ethicon, Inc, Somerville, NJ) (42%) or polypropylene (48%). Twenty subjects (6%) experienced mesh/suture erosion. Unadjusted risk factors for mesh/suture erosion were expanded polytrafluroethylene (ePTFE) mesh (ePTFE 4/21 [19%] vs non-ePTFE 16/301 [5%]; odds ratio [OR], 4.2), concurrent hysterectomy (OR, 4.9), and current smoking (OR, 5.2). Of those with mesh erosion, most affected women (13/17) underwent at least 1 surgery for partial or total mesh removal. Two were completely resolved, 6 had persistent problems, and 5 were lost to follow-up. No resolution was documented in the 4 women who elected observation.CONCLUSION: Expanded PTFE mesh should not be used for sacral colpopexy. Concurrent hysterectomy and smoking are modifiable risks for mesh/suture erosion.