Cystopexy raises the post-operative complication rate during laparoscopic hysterectomy for uterine prolapse.

IF 1.6 4区医学 Q2 SURGERY

Frontiers in Surgery Pub Date : 2025-04-30 eCollection Date: 2025-01-01 DOI:10.3389/fsurg.2025.1488775

Carlo Ronsini, Giada Andreoli, Marco Torella, Paola Romeo, Giuseppe Sarpietro, Stefano Cianci

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引用次数: 0

Abstract

Objectives: This study aims to compare the outcomes of laparoscopic colposuspension sec Shull (LCSS) and laparoscopic colposacropexy (LCSP) with and without the addition of cystopexy for the treatment of pelvic organ prolapse (POP) in terms of postoperative complications, recurrence rates, and overall effectiveness.

Materials and methods: A retrospective case-control analysis was conducted on women treated for grade 3-4 POP-Q uterine prolapse at the Academic Departments of Gynaecology and Obstetrics of "G. Martino" of Messina, Italy, and "L. Vanvitelli" of Napoli, Italy, between November 2020 and February 2022. Group A consisted of patients who underwent laparoscopic hysterectomy followed by LCSS or LCSP without cystopexy. At the same time, Group B included patients who had the same procedures with the addition of cystopexy. Data on complications were collected using the Clavien-Dindo classification, and prolapse recurrence was monitored according to the POP-Q system. Statistical analysis was performed using Fisher's exact, Chi-squared, and Wilcoxon rank-sum tests.

Results: A total of 148 patients were included, with 125 in Group A and 23 in Group B. Group B showed a significantly higher rate of postoperative complications (16%) compared to Group A (2.4%) (p = 0.016), with an Odds Ratio of 7.62 (95% CI 1.59-36.51, p = 0.0017). No significant difference between the groups was found in the recurrence rate of prolapse at 24 months (p > 0.9).

Conclusion: Adding cystopexy to LCSS or LCSP increases the risk of postoperative complications without reducing prolapse recurrence rates. Further research is needed to identify patients who may benefit from cystopexy and to evaluate its impact on stress incontinence and patient satisfaction.

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腹腔镜子宫切除术治疗子宫脱垂的并发症发生率增高。

目的：本研究旨在比较腹腔镜阴道悬吊术（LCSS）和腹腔镜阴道肩固定术（LCSP）治疗盆腔器官脱垂（POP）的术后并发症、复发率和总体疗效。材料与方法：回顾性病例对照分析意大利墨西拿“G. Martino”妇产科和那不勒斯“L. Vanvitelli”妇产科于2020年11月至2022年2月收治的3-4级POP-Q型子宫脱垂患者。A组为行腹腔镜子宫切除术后行LCSS或LCSP而不进行膀胱切除术的患者。与此同时，B组患者采用相同的手术，并进行膀胱切除术。采用Clavien-Dindo分类收集并发症数据，并根据POP-Q系统监测脱垂复发情况。采用Fisher精确检验、卡方检验和Wilcoxon秩和检验进行统计分析。结果：共纳入148例患者，A组125例，B组23例。B组术后并发症发生率（16%）明显高于A组（2.4%）（p = 0.016），优势比为7.62 （95% CI 1.59 ~ 36.51, p = 0.0017）。两组患者24个月脱垂复发率差异无统计学意义（p < 0.05）。结论：LCSS或LCSP加膀胱封锁术可增加术后并发症风险，但不能降低脱垂复发率。需要进一步的研究来确定可能受益于膀胱切除术的患者，并评估其对压力性尿失禁和患者满意度的影响。

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

Frontiers in Surgery Medicine-Surgery

CiteScore

1.90

自引率

11.10%

发文量

1872

审稿时长

12 weeks

期刊介绍： Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles. Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery. Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact. The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.