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Early safety and efficiency outcomes of a novel interdisciplinary laparoscopic resection rectopexy combined with sacrocolpopexy for women with obstructive defecation syndrome and pelvic organ prolapse: a single center study

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Název: Early safety and efficiency outcomes of a novel interdisciplinary laparoscopic resection rectopexy combined with sacrocolpopexy for women with obstructive defecation syndrome and pelvic organ prolapse: a single center study
Autoři: Rudroff, Claudia, Madukkakuzhy, Joshy, Hernandez, Alberto Vega, Otten, Jakob, Ulrici, Christoph, Karapanos, Leonidas, Ludwig, Sebastian
Zdroj: BMC Surg
BMC Surgery, Vol 24, Iss 1, Pp 1-13 (2024)
Informace o vydavateli: Springer Science and Business Media LLC, 2023.
Rok vydání: 2023
Témata: Obstructed defecation syndrome, Synthetic mesh, RD1-811, Pelvic Organ Prolapse, 03 medical and health sciences, Gynecologic Surgical Procedures, Postoperative Complications, 0302 clinical medicine, Humans, Defecation, Aged, Retrospective Studies, Sacrocolpopexy, Resection rectopexy, Vagina/surgery [MeSH], Aged [MeSH], Constipation/surgery [MeSH], Postoperative Complications/epidemiology [MeSH], Pelvic Organ Prolapse/surgery [MeSH], Defecation/physiology [MeSH], Biological mesh, Surgical Mesh [MeSH], Gynecologic Surgical Procedures/methods [MeSH], Postoperative Complications/etiology [MeSH], Female [MeSH], Laparoscopy/methods [MeSH], Pelvic Organ Prolapse/complications [MeSH], Rectum/surgery [MeSH], Humans [MeSH], Syndrome [MeSH], Treatment Outcome [MeSH], Retrospective Studies [MeSH], Middle Aged [MeSH], Constipation/etiology [MeSH], Research, Pelvic organ prolapse, Rectum, Syndrome, Middle Aged, Surgical Mesh, 3. Good health, Treatment Outcome, Vagina, Surgery, Female, Laparoscopy, Constipation
Popis: Background Obstructive defecation syndrome (ODS) defines a disturbed defecation process frequently associated with pelvic organ prolapse (POP) in women that substantially compromises quality of life. Conservative management offers limited relief and a surgical intervention may be required. This is characterized by individual approaches. Aim of the study This retrospective single center study evaluated the surgical and clinical short-term outcome of a novel interdisciplinary laparoscopic resection rectopexy (L-RRP) with mesh- sacrocolpopexy (L-SCP) for women suffering from ODS and POP. Methods The study participants underwent surgery in an interdisciplinary laparoscopic approach. Safety was the primary endpoint, assessed via postoperative morbidity classified by Clavien-Dindo scale. Secondary outcomes included evaluation of bowel function, fecal and urinary incontinence and pelvic organ prolapse status at 12 months follow-up. Additionally, a biological mesh (BM) was offered to women, who asked for an alternative to synthetic mesh material (SM). Results Of the 44 consecutive patients requiring surgery for ODS and POP, 36 patients underwent the interdisciplinary surgical approach; 28 patients with SM and 8 patients with BM. In total 5 complications occurred, four of them were classified as minor. One minor complication was observed in the BM group. One anastomotic leakage occurred in the SM group. The two ODS scores, the bowel dysfunction score, and the incontinence score improved significantly (p = 0.006, p = 0.003, p p = 0.0035, respectively). Pelvic floor anatomy was fully restored (POP-Q 0) for 29 (80%) patients after surgery. 17 patients (47%) suffered from urinary incontinence before surgery, which was restored in 13 patients (76.5%). Conclusions The interdisciplinary approach with L-RRP and L-SCP and the use of a BM in a small subgroup were technically feasible, safe, and effective in this single center setting. The study’s retrospective design, the small sample size and the lack of comparators limit the generalizability of the findings requiring future randomized trials. Trial registration Retrospectively registered at clinicaltrials.gov, trial number NCT05910021, date of registration 06/10/2023.
Druh dokumentu: Article
Other literature type
Jazyk: English
ISSN: 1471-2482
DOI: 10.1186/s12893-024-02474-4
DOI: 10.21203/rs.3.rs-3046952/v1
Přístupová URL adresa: https://pubmed.ncbi.nlm.nih.gov/38877450
https://doaj.org/article/8fad07d4bc8f4bf5b0879432d3cf121a
https://repository.publisso.de/resource/frl:6517820
Rights: CC BY
URL: http://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (http://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (http://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Přístupové číslo: edsair.doi.dedup.....d1b4324d109faea6d88fd6cfd63c494e
Databáze: OpenAIRE
Popis
Abstrakt:Background Obstructive defecation syndrome (ODS) defines a disturbed defecation process frequently associated with pelvic organ prolapse (POP) in women that substantially compromises quality of life. Conservative management offers limited relief and a surgical intervention may be required. This is characterized by individual approaches. Aim of the study This retrospective single center study evaluated the surgical and clinical short-term outcome of a novel interdisciplinary laparoscopic resection rectopexy (L-RRP) with mesh- sacrocolpopexy (L-SCP) for women suffering from ODS and POP. Methods The study participants underwent surgery in an interdisciplinary laparoscopic approach. Safety was the primary endpoint, assessed via postoperative morbidity classified by Clavien-Dindo scale. Secondary outcomes included evaluation of bowel function, fecal and urinary incontinence and pelvic organ prolapse status at 12 months follow-up. Additionally, a biological mesh (BM) was offered to women, who asked for an alternative to synthetic mesh material (SM). Results Of the 44 consecutive patients requiring surgery for ODS and POP, 36 patients underwent the interdisciplinary surgical approach; 28 patients with SM and 8 patients with BM. In total 5 complications occurred, four of them were classified as minor. One minor complication was observed in the BM group. One anastomotic leakage occurred in the SM group. The two ODS scores, the bowel dysfunction score, and the incontinence score improved significantly (p = 0.006, p = 0.003, p p = 0.0035, respectively). Pelvic floor anatomy was fully restored (POP-Q 0) for 29 (80%) patients after surgery. 17 patients (47%) suffered from urinary incontinence before surgery, which was restored in 13 patients (76.5%). Conclusions The interdisciplinary approach with L-RRP and L-SCP and the use of a BM in a small subgroup were technically feasible, safe, and effective in this single center setting. The study’s retrospective design, the small sample size and the lack of comparators limit the generalizability of the findings requiring future randomized trials. Trial registration Retrospectively registered at clinicaltrials.gov, trial number NCT05910021, date of registration 06/10/2023.
ISSN:14712482
DOI:10.1186/s12893-024-02474-4