One-Year Functional and Anatomic Outcomes of Robotic Sacrocolpopexy Versus Vaginal Extraperitoneal Colpopexy With Mesh
One-Year Functional and Anatomic Outcomes of Robotic Sacrocolpopexy Versus Vaginal Extraperitoneal Colpopexy With Mesh
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DOI：
10.1097/spv.0000000000000120
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发表时间：
2015-03
影响因子：
1.6
通讯作者：
L. H. Jambusaria;M. Murphy;V. Lucente
中科院分区：
文献类型：
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作者：
L. H. Jambusaria;M. Murphy;V. Lucente
目的评价和比较经阴道和经腹人工合成网片强化骨盆器官脱垂修补术(POP)后1年的解剖和功能结果。方法对2008年12月至2011年3月接受机器人辅助腹膜外固定术(RALSC)和阴式腹膜外固定术(VEC)的患者进行回顾性配对队列研究。我们比较了手术前和术后1年随访组间解剖、生活质量和功能的变化。一年的手术满意度也被评估。结果38例RALSC患者符合纳入标准，年龄和手术时间与38例VEC患者相匹配。在这些患者中，31名RALSC和30名VEC患者(80%)有完整的1年数据。两组患者手术前和术后的结果相似，在解剖盆腔器官脱垂量化测量和功能问卷评分方面也有相似的改善。两组患者均表现出较高的手术满意度。症状自评量表显示RALSC和VEC患者的症状性“隆起”消退率分别为84%和90%(P=0.74)。RALSC组的手术时间显著延长了约96分钟，全身麻醉的使用也更多(P=0.001)。在出血量、住院天数或恢复正常排尿方面，两组之间没有差异。结论在这项回顾性队列研究中，使用合成网状植入物的经腹和经阴道固定术在改善生活质量和解剖学措施方面取得了相似的结果。机器人辅助的腹腔镜固定术更多地使用全身麻醉和更长的手术时间。
Objectives This study aimed to evaluate and compare 1-year anatomic and functional outcomes in patients undergoing transvaginal versus transabdominal repair of pelvic organ prolapse (POP) with synthetic mesh reinforcement. Methods We conducted a retrospective, matched cohort study of patients undergoing robotic-assisted laparoscopic sacrocolpopexy (RALSC) and vaginal extraperitoneal colpopexy (VEC) with synthetic mesh from December 2008 to March 2011. We compared the preoperative to postoperative changes in anatomic, quality of life, and functional outcomes between groups after 1 year of follow-up. One-year surgical satisfaction was also assessed. Results Thirty-eight RALSC patients met the inclusion criteria and were matched by age and month of surgery to 38 VEC patients. Of those, 31 RALSC and 30 VEC patients (80%) had complete 1-year data. Preoperative to postoperative outcomes were similar in both groups with similar improvement seen in anatomic Pelvic Organ Prolapse Quantification measures as well as functional questionnaire scores. Both groups demonstrated high surgical satisfaction. Symptom distress inventory scales revealed 84% and 90% resolution of symptomatic “bulge” in RALSC and VEC patients, respectively (P = 0.74). The RALSC group had a significantly greater operative time by approximately 96 minutes and greater use of general anesthesia (P = <0.001). No difference was noted in blood loss, hospital days, or return to normal voiding between groups. Conclusions Transabdominal and transvaginal techniques of colpopexy using synthetic mesh implants for POP have been shown in this retrospective cohort study to improve quality of life and anatomic measures with similar outcomes. Robotic-assisted laparoscopic sacrocolpopexy results in a greater use of general anesthesia and longer operative time.