Efficacy and safety of laparoscopic lateral suspension with mesh for pelvic organ prolapse: A systematic review and meta-analysis.

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Acta Obstetricia et Gynecologica Scandinavica Pub Date : 2025-06-11 DOI:10.1111/aogs.15170

Qi Wang, Stefano Manodoro, Xiaoxiang Jiang, Chaoqin Lin

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Abstract

Introduction: Laparoscopic lateral suspension (LLS) with mesh is an alternative treatment for pelvic organ prolapse, offering enhanced apical vaginal suspension. This review aims to comprehensively evaluate the efficacy and safety of LLS for the treatment of pelvic organ prolapse through systematic review and meta-analysis.

Material and methods: Original studies including randomized controlled trials, prospective, or retrospective studies reporting outcomes on the efficacy and safety of LLS with mesh for pelvic organ prolapse were retrieved from PubMed and Web of Science up to November 30, 2024. Case reports, reviews, and non-English literature were excluded. Primary outcomes included anatomical and subjective success rates. Secondary outcomes were recurrence rates, reoperation rates, and complications. Random-effects meta-analysis was performed where appropriate. This study has been registered in PROSPERO with the registration number CRD42024620632.

Results: Eighteen studies (3 randomized controlled trials, 9 prospective studies, and 6 retrospective studies) involving 1430 LLS patients with a mean follow-up of 20.27 months were included. The pooled anatomical success rates for the apical and anterior compartments were 92.9% (95% confidence interval [CI]: 89.8-95.1) and 86.9% (95% CI: 81.4-90.9), respectively. The subjective success rate was 88.9% (95% CI: 85.3-91.7). The pooled recurrence rate was 9.6% (95% CI: 7.0-13.2), and the reoperation rate was 6.2% (95% CI: 4.3-8.9). Overall complication and mesh-related complication rates were 5.7% (95% CI: 3.4-9.4) and 1.9% (95% CI: 1.0-3.8), respectively. The incidence of Clavien-Dindo grade ≥3 complications was only 1.9% (16/848).

Conclusions: LLS demonstrates favorable anatomical and subjective success rates, indicating its reliability and safety for pelvic organ prolapse treatment. However, longer follow-up is needed to validate its long-term efficacy.

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腹腔镜下带网状物侧悬吊治疗盆腔器官脱垂的疗效和安全性：一项系统综述和荟萃分析。

腹腔镜侧悬吊（LLS）与网状物是盆腔器官脱垂的另一种治疗方法，提供增强的阴道顶端悬吊。本综述旨在通过系统综述和荟萃分析，综合评价LLS治疗盆腔器官脱垂的疗效和安全性。材料和方法：截至2024年11月30日，从PubMed和Web of Science检索原始研究，包括随机对照试验、前瞻性或回顾性研究，报告了LLS加补片治疗盆腔器官脱垂的疗效和安全性。排除病例报告、综述和非英语文献。主要结果包括解剖和主观成功率。次要结果为复发率、再手术率和并发症。适当时进行随机效应荟萃分析。本研究已在PROSPERO注册，注册号为CRD42024620632。结果：纳入18项研究（3项随机对照试验，9项前瞻性研究，6项回顾性研究），共纳入1430例LLS患者，平均随访20.27个月。根尖室和前室的总解剖成功率分别为92.9%（95%可信区间[CI]: 89.8-95.1）和86.9% （95% CI: 81.4-90.9）。主观成功率为88.9% （95% CI: 85.3-91.7）。合并复发率为9.6% (95% CI: 7.0 ~ 13.2)，再手术率为6.2% （95% CI: 4.3 ~ 8.9）。总并发症和网片相关并发症发生率分别为5.7% （95% CI: 3.4-9.4）和1.9% （95% CI: 1.0-3.8）。Clavien-Dindo≥3级并发症发生率仅为1.9%（16/848）。结论：LLS具有良好的解剖学和主观成功率，表明其治疗盆腔器官脱垂的可靠性和安全性。然而，需要更长的随访时间来验证其长期疗效。

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

Acta Obstetricia et Gynecologica Scandinavica 医学-妇产科学

CiteScore

8.00

自引率

4.70%

发文量

180

审稿时长

3-6 weeks

期刊介绍： Published monthly, Acta Obstetricia et Gynecologica Scandinavica is an international journal dedicated to providing the very latest information on the results of both clinical, basic and translational research work related to all aspects of women’s health from around the globe. The journal regularly publishes commentaries, reviews, and original articles on a wide variety of topics including: gynecology, pregnancy, birth, female urology, gynecologic oncology, fertility and reproductive biology.