Sacrocolpopexy: Alternatives to Mesh Grafts.

IF 1.8 3区医学 Q3 OBSTETRICS & GYNECOLOGY

International Urogynecology Journal Pub Date : 2024-10-30 DOI:10.1007/s00192-024-05956-4

Chin Yong, Mooska Raoofi, Marcus Carey

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引用次数: 0

Abstract

Introduction and hypothesis: The ongoing pelvic mesh controversy, coupled with a regulatory pause in using pelvic mesh in some countries, has created a need for mesh-free alternatives for sacrocolpopexy (SCP). This article provides an overview of mesh-free alternatives for SCP.

Methods: MEDLINE and PubMed searches were conducted to identify studies reporting on autologous and non-autologous biologic grafts for SCP. Identified studies were reviewed by two of the authors (CY and MR).

Results: Emerging evidence on autologous fascia lata (AFL) and rectus sheath (ARS) for SCP is promising, with low donor site morbidity. Non-autologous biologic grafts for SCP are mostly reported to be inferior to mesh.

Conclusions: Emerging evidence suggests that AFL and ARS might be safe and effective alternative options to mesh SCP. The main advantages of AFL for SCP over ARS are laparoscopy or robot-assisted laparoscopy approaches, and that a larger graft can be safely harvested. The benefits of utilising allografts and xenografts are limited by their reduced durability compared with mesh and patient acceptability.

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骶骨整形术：网片移植的替代方案。

导言和假设：盆腔网片争议不断，加之一些国家暂停使用盆腔网片的监管措施，使得骶尾部结扎术（SCP）需要无网片替代品。本文概述了 SCP 的无网片替代品：方法：对 MEDLINE 和 PubMed 进行了检索，以确定报道用于 SCP 的自体和非自体生物移植物的研究。两位作者（CY 和 MR）对确定的研究进行了审查：结果：关于自体筋膜（AFL）和直肌鞘（ARS）用于 SCP 的新证据前景看好，供体部位发病率低。非自体生物移植物用于 SCP 的效果大多不如网片：新的证据表明，AFL 和 ARS 可能是安全有效的网状 SCP 替代选择。与 ARS 相比，AFL 用于 SCP 的主要优势在于腹腔镜或机器人辅助腹腔镜方法，而且可以安全地采集较大的移植物。与网片相比，异体移植物和异种移植物的耐久性较差，患者的接受程度也较低，因此使用异体移植物和异种移植物的优势有限。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Urogynecology Journal 医学-妇产科学

CiteScore

3.80

自引率

22.20%

发文量

406

审稿时长

3-6 weeks

期刊介绍： The International Urogynecology Journal is the official journal of the International Urogynecological Association (IUGA).The International Urogynecology Journal has evolved in response to a perceived need amongst the clinicians, scientists, and researchers active in the field of urogynecology and pelvic floor disorders. Gynecologists, urologists, physiotherapists, nurses and basic scientists require regular means of communication within this field of pelvic floor dysfunction to express new ideas and research, and to review clinical practice in the diagnosis and treatment of women with disorders of the pelvic floor. This Journal has adopted the peer review process for all original contributions and will maintain high standards with regard to the research published therein. The clinical approach to urogynecology and pelvic floor disorders will be emphasized with each issue containing clinically relevant material that will be immediately applicable for clinical medicine. This publication covers all aspects of the field in an interdisciplinary fashion