Laparoscopic lateral suspension for pelvic organ prolapse: A systematic literature review.
Laparoscopy
Lateral suspension
Mesh
Pelvic organ prolapse
Robotic surgery
Systematic review
Journal
European journal of obstetrics, gynecology, and reproductive biology
ISSN: 1872-7654
Titre abrégé: Eur J Obstet Gynecol Reprod Biol
Pays: Ireland
ID NLM: 0375672
Informations de publication
Date de publication:
Sep 2021
Sep 2021
Historique:
received:
30
03
2021
revised:
14
06
2021
accepted:
25
07
2021
pubmed:
8
8
2021
medline:
22
9
2021
entrez:
7
8
2021
Statut:
ppublish
Résumé
Abdominal lateral suspension with mesh represents an alternative treatment to suspend the vaginal apex. The aim of this study was to summarize literature data regarding the anatomical and functional outcomes, and intra- and postoperative complications of this technique with minimally invasive approach (laparoscopic/robotic). Systematic literature search using MEDLINE/PubMed, SCOPUS, Web of Science. Two authors extracted data on baseline characteristics (age, BMI, prior pelvic reconstructive surgery, preoperative POP stage), perioperative outcomes (operative time, estimated blood loss, intraoperative and postoperative complications, admission time), objective and subjective success rate, surgical failure, time of follow-up. Data were presented descriptively. Thirteen studies were included in the review. The overall number of patients for our analysis was 1066. Patients referred for laparoscopic/robotic lateral suspension were most frequently postmenopausal, aged 50 to 65 years, BMI ≥ 25 kg/m2; 22.2% were already hysterectomized, while 17% had already a previous POP surgery. Operative time ranged from 78.4 ± 29.7 to 254 ± 45 min. The overall anatomic success was more than 90% in the apical compartment and more than 88% in the anterior compartment. Subjective cure rate varies from 78.4% to 100% in medium-term follow-up. Post-operative complication grade >= 3 according to Claiven-Dindo Scale was 1.03%. Mesh erosion rate varied between 0% and 13%. Results coming from our systematic review suggest safety, efficacy and feasibility of minimally invasive lateral suspension with optimal anatomical and functional outcomes. Well-designed, randomized, controlled trials are required to confirm this data.
Sections du résumé
BACKGROUND
BACKGROUND
Abdominal lateral suspension with mesh represents an alternative treatment to suspend the vaginal apex.
OBJECTIVES
OBJECTIVE
The aim of this study was to summarize literature data regarding the anatomical and functional outcomes, and intra- and postoperative complications of this technique with minimally invasive approach (laparoscopic/robotic).
SEARCH STRATEGY
METHODS
Systematic literature search using MEDLINE/PubMed, SCOPUS, Web of Science.
DATA COLLECTION AND ANALYSIS
METHODS
Two authors extracted data on baseline characteristics (age, BMI, prior pelvic reconstructive surgery, preoperative POP stage), perioperative outcomes (operative time, estimated blood loss, intraoperative and postoperative complications, admission time), objective and subjective success rate, surgical failure, time of follow-up. Data were presented descriptively.
MAIN RESULTS
RESULTS
Thirteen studies were included in the review. The overall number of patients for our analysis was 1066. Patients referred for laparoscopic/robotic lateral suspension were most frequently postmenopausal, aged 50 to 65 years, BMI ≥ 25 kg/m2; 22.2% were already hysterectomized, while 17% had already a previous POP surgery. Operative time ranged from 78.4 ± 29.7 to 254 ± 45 min. The overall anatomic success was more than 90% in the apical compartment and more than 88% in the anterior compartment. Subjective cure rate varies from 78.4% to 100% in medium-term follow-up. Post-operative complication grade >= 3 according to Claiven-Dindo Scale was 1.03%. Mesh erosion rate varied between 0% and 13%.
CONCLUSIONS
CONCLUSIONS
Results coming from our systematic review suggest safety, efficacy and feasibility of minimally invasive lateral suspension with optimal anatomical and functional outcomes. Well-designed, randomized, controlled trials are required to confirm this data.
Identifiants
pubmed: 34364019
pii: S0301-2115(21)00388-2
doi: 10.1016/j.ejogrb.2021.07.044
pii:
doi:
Types de publication
Journal Article
Review
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
318-329Informations de copyright
Copyright © 2021 Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.