Patient satisfaction after laparoscopic lateral suspension with mesh for pelvic organ prolapse: outcome report of a continuous series of 417 patients

被引:71
作者
Veit-Rubin, Nikolaus [1 ,2 ]
Dubuisson, Jean-Bernard [1 ,3 ]
Gayet-Ageron, Angele [1 ,4 ,5 ]
Lange, Soren [1 ,6 ]
Eperon, Isabelle [1 ,6 ]
Dubuisson, Jean [1 ,6 ]
机构
[1] Univ Geneva, Fac Med, Geneva, Switzerland
[2] Med Univ Vienna, Dept Obstet & Gynecol, Vienna, Austria
[3] Clin La Colline, Gynaecol Ctr, Geneva, Switzerland
[4] Univ Hosp Geneva, CRC, Geneva, Switzerland
[5] Univ Hosp Geneva, Dept Hlth & Community Med, Div Clin Epidemiol, Geneva, Switzerland
[6] Univ Hosp Geneva, Dept Obstet & Gynecol, Geneva, Switzerland
关键词
Pelvic organ prolapse; Laparoscopic lateral suspension; Patient satisfaction; Mesh surgery; GENITAL PROLAPSE; CLASSIFICATION; SACROCOLPOPEXY; GRAFTS; TERMINOLOGY; VALIDATION; PROSTHESES; SURGERY;
D O I
10.1007/s00192-017-3327-2
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Introduction and hypothesis Sacropexy is considered the gold standard for the treatment of pelvic organ prolapse (POP) although dissection of the promontory may be challenging, particularly in obese women. Laparoscopic lateral suspension with mesh (LLS) could be an alternative. Methods LLS provides lateral attachment by fibrosis of a vesicovaginal mesh. Clinical evaluation was performed at 1 year using the simplified POP quantification system (POP-Q). Primary outcomes were objective and subjective cure at 1 year. After a mean of 7.2 years the rates of reoperation and complications were assessed as secondary outcomes. Patient satisfaction was evaluated by telephone interview using a ten-point-scale and the PGI-I scale. Factors predicting satisfaction were determined by logistic regression analysis. Results A total of 417 patients were treated between 2003 and 2011. At 1 year 78.4% of patients were asymptomatic and anatomic success rates were 91.6% for the anterior compartment, 93.6% for the apical compartment and 85.3% for the posterior compartment. The complication rate of ClavienDindo grade III or higher was 2.2%. The mesh exposure rate was 4.3% and the reoperation rate was 7.3%. Of the 417 patients, 214 participated in the telephone interview. Over 85% rated their situation as improved and satisfaction was associated with the absence of concomitant hysterectomy. Conclusions LLS is a safe technique with promising results in terms of a composite outcome, low complication rates and high long-term patient satisfaction. However, a randomized controlled trial is needed to establish the technique as an alternative to sacropexy in the treatment of POP in obese and high morbidity patients.
引用
收藏
页码:1685 / 1693
页数:9
相关论文
共 29 条
[1]  
[Anonymous], OBSTET GYNECOL, DOI DOI 10.1016/J.AJ0G.2007.02.051
[2]   Apical prolapse [J].
Barber, Matthew D. ;
Maher, Christopher .
INTERNATIONAL UROGYNECOLOGY JOURNAL, 2013, 24 (11) :1815-1833
[3]   Epidemiology and outcome assessment of pelvic organ prolapse [J].
Barber, Matthew D. ;
Maher, Christopher .
INTERNATIONAL UROGYNECOLOGY JOURNAL, 2013, 24 (11) :1783-1790
[4]   Defining Success After Surgery for Pelvic Organ Prolapse [J].
Barber, Matthew D. ;
Brubaker, Linda ;
Nygaard, Ingrid ;
Wheeler, Thomas L., II ;
Schaffer, Joeseph ;
Chen, Zhen ;
Spino, Cathie .
OBSTETRICS AND GYNECOLOGY, 2009, 114 (03) :600-609
[5]   The role of synthetic and biological prostheses in reconstructive pelvic floor surgery [J].
Birch, C ;
Fynes, MM .
CURRENT OPINION IN OBSTETRICS & GYNECOLOGY, 2002, 14 (05) :527-535
[6]   Medium-Term Anatomic and Functional Results of Laparoscopic Sacrocolpopexy Beyond the Learning Curve [J].
Claerhout, Filip ;
De Ridder, Dirk ;
Roovers, Jan Paul ;
Rommens, Heidi ;
Spelzini, Federico ;
Vandenbroucke, Vanessa ;
Coremans, Georges ;
Deprest, Jan .
EUROPEAN UROLOGY, 2009, 55 (06) :1459-1468
[7]   The Clavien-Dindo Classification of Surgical Complications Five-Year Experience [J].
Clavien, Pierre A. ;
Barkun, Jeffrey ;
de Oliveira, Michelle L. ;
Vauthey, Jean Nicolas ;
Dindo, Daniel ;
Schulick, Richard D. ;
de Santibanes, Eduardo ;
Pekolj, Juan ;
Slankamenac, Ksenija ;
Bassi, Claudio ;
Graf, Rolf ;
Vonlanthen, Rene ;
Padbury, Robert ;
Cameron, John L. ;
Makuuchi, Masatoshi .
ANNALS OF SURGERY, 2009, 250 (02) :187-196
[8]   Clinical implications of the biology of grafts: conclusions of the 2005 IUGA Grafts Roundtable [J].
Davila, G. Willy ;
Drutz, Harold ;
Deprest, Jan .
INTERNATIONAL UROGYNECOLOGY JOURNAL, 2006, 17 (Suppl 1) :S51-S55
[9]   Treatment of genital prolapse by laparoscopic lateral suspension using mesh: A series of 73 patients [J].
Dubuisson, Jean-Bernard ;
Yaron, Michal ;
Wenger, Jean-Marie ;
Jacob, Sandrine .
JOURNAL OF MINIMALLY INVASIVE GYNECOLOGY, 2008, 15 (01) :49-55
[10]   Uterine-preserving POP surgery [J].
Gutman, Robert ;
Maher, Christopher .
INTERNATIONAL UROGYNECOLOGY JOURNAL, 2013, 24 (11) :1803-1813