Mart C. P. Kortman, Jan W. P. Vanstiphout, Akeel Alhafidh, Frank F. J. Simonis, Anique T. M. Grob
{"title":"骶直肠固定术对直立体位骨盆解剖的影响","authors":"Mart C. P. Kortman, Jan W. P. Vanstiphout, Akeel Alhafidh, Frank F. J. Simonis, Anique T. M. Grob","doi":"10.1111/codi.70114","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aim</h3>\n \n <p>Rectopexy with concomitant sacrocolpopexy (sacrocolporectopexy) is the favoured technique for treating combined pelvic organ prolapse and internal or external rectal prolapse, despite limited functional improvement. Previous studies have assessed anatomical change after standalone rectopexy or sacrocolpopexy, based on supine MRI defaecography. Since a supine position can underestimate the extent of pelvic organ prolapse, it might also incorrectly assess the anatomical effect of sacrocolporectopexy. The aim of this study was to assess the effect of sacrocolporectopexy on the pelvic anatomy in an upright position.</p>\n </section>\n \n <section>\n \n <h3> Method</h3>\n \n <p>Twenty one female patients undergoing sacrocolporectopexy from December 2022 to June 2024 were included. All patients underwent physical examination and MRI defaecography preoperatively and postoperatively. The descent of the bladder, vaginal vault and anorectal junction and the size of the rectocele and enterocele were assessed on the MRI defaecography images during maximum straining. Significance was tested using a paired <i>t</i>-test and an improvement of ≥10 mm was considered clinically relevant. The results were compared with previous studies, which used supine assessment.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Postoperative improvement was found for the bladder, vaginal vault, anorectal junction, rectocele and enterocele with 14, 44, 5, 16 and 54 mm respectively. The bladder, vaginal vault, rectocele and enterocele showed clinically relevant improvement. Compared with supine results, upright assessments revealed a larger organ lift for the vaginal vault as well as a higher, overall, position of the anorectal junction.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Upright assessment of sacrocolporectopexy differs from supine assessment, with statistical and clinically relevant lift for the pelvic organs.</p>\n </section>\n </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 5","pages":""},"PeriodicalIF":2.9000,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/codi.70114","citationCount":"0","resultStr":"{\"title\":\"The influence of sacrocolporectopexy on pelvic anatomy assessed in an upright position using MRI\",\"authors\":\"Mart C. P. Kortman, Jan W. P. Vanstiphout, Akeel Alhafidh, Frank F. J. Simonis, Anique T. M. Grob\",\"doi\":\"10.1111/codi.70114\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Aim</h3>\\n \\n <p>Rectopexy with concomitant sacrocolpopexy (sacrocolporectopexy) is the favoured technique for treating combined pelvic organ prolapse and internal or external rectal prolapse, despite limited functional improvement. Previous studies have assessed anatomical change after standalone rectopexy or sacrocolpopexy, based on supine MRI defaecography. Since a supine position can underestimate the extent of pelvic organ prolapse, it might also incorrectly assess the anatomical effect of sacrocolporectopexy. The aim of this study was to assess the effect of sacrocolporectopexy on the pelvic anatomy in an upright position.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Method</h3>\\n \\n <p>Twenty one female patients undergoing sacrocolporectopexy from December 2022 to June 2024 were included. All patients underwent physical examination and MRI defaecography preoperatively and postoperatively. The descent of the bladder, vaginal vault and anorectal junction and the size of the rectocele and enterocele were assessed on the MRI defaecography images during maximum straining. Significance was tested using a paired <i>t</i>-test and an improvement of ≥10 mm was considered clinically relevant. The results were compared with previous studies, which used supine assessment.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Postoperative improvement was found for the bladder, vaginal vault, anorectal junction, rectocele and enterocele with 14, 44, 5, 16 and 54 mm respectively. The bladder, vaginal vault, rectocele and enterocele showed clinically relevant improvement. Compared with supine results, upright assessments revealed a larger organ lift for the vaginal vault as well as a higher, overall, position of the anorectal junction.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>Upright assessment of sacrocolporectopexy differs from supine assessment, with statistical and clinically relevant lift for the pelvic organs.</p>\\n </section>\\n </div>\",\"PeriodicalId\":10512,\"journal\":{\"name\":\"Colorectal Disease\",\"volume\":\"27 5\",\"pages\":\"\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2025-05-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1111/codi.70114\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Colorectal Disease\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/codi.70114\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Colorectal Disease","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/codi.70114","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
The influence of sacrocolporectopexy on pelvic anatomy assessed in an upright position using MRI
Aim
Rectopexy with concomitant sacrocolpopexy (sacrocolporectopexy) is the favoured technique for treating combined pelvic organ prolapse and internal or external rectal prolapse, despite limited functional improvement. Previous studies have assessed anatomical change after standalone rectopexy or sacrocolpopexy, based on supine MRI defaecography. Since a supine position can underestimate the extent of pelvic organ prolapse, it might also incorrectly assess the anatomical effect of sacrocolporectopexy. The aim of this study was to assess the effect of sacrocolporectopexy on the pelvic anatomy in an upright position.
Method
Twenty one female patients undergoing sacrocolporectopexy from December 2022 to June 2024 were included. All patients underwent physical examination and MRI defaecography preoperatively and postoperatively. The descent of the bladder, vaginal vault and anorectal junction and the size of the rectocele and enterocele were assessed on the MRI defaecography images during maximum straining. Significance was tested using a paired t-test and an improvement of ≥10 mm was considered clinically relevant. The results were compared with previous studies, which used supine assessment.
Results
Postoperative improvement was found for the bladder, vaginal vault, anorectal junction, rectocele and enterocele with 14, 44, 5, 16 and 54 mm respectively. The bladder, vaginal vault, rectocele and enterocele showed clinically relevant improvement. Compared with supine results, upright assessments revealed a larger organ lift for the vaginal vault as well as a higher, overall, position of the anorectal junction.
Conclusion
Upright assessment of sacrocolporectopexy differs from supine assessment, with statistical and clinically relevant lift for the pelvic organs.
期刊介绍：
Diseases of the colon and rectum are common and offer a number of exciting challenges. Clinical, diagnostic and basic science research is expanding rapidly. There is increasing demand from purchasers of health care and patients for clinicians to keep abreast of the latest research and developments, and to translate these into routine practice. Technological advances in diagnosis, surgical technique, new pharmaceuticals, molecular genetics and other basic sciences have transformed many aspects of how these diseases are managed. Such progress will accelerate.
Colorectal Disease offers a real benefit to subscribers and authors. It is first and foremost a vehicle for publishing original research relating to the demanding, rapidly expanding field of colorectal diseases.
Essential for surgeons, pathologists, oncologists, gastroenterologists and health professionals caring for patients with a disease of the lower GI tract, Colorectal Disease furthers education and inter-professional development by including regular review articles and discussions of current controversies.
Note that the journal does not usually accept paediatric surgical papers.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
