Outcomes of Robotic Sacrocolpopexy: A Systematic Review and Meta-analysis
Identifieur interne : 000A51 ( Pmc/Checkpoint ); précédent : 000A50; suivant : 000A52Outcomes of Robotic Sacrocolpopexy: A Systematic Review and Meta-analysis
Auteurs : Catherine O. Hudson [États-Unis] ; Gina M. Northington [États-Unis] ; Robert H. Lyles [États-Unis] ; Deborah R. Karp [États-Unis]Source :
- Female pelvic medicine & reconstructive surgery [ 2151-8378 ] ; 2014.
Abstract
Robotic sacrocolpopexy has been rapidly incorporated into surgical practice without comprehensive and systematically published outcome data. The aim of this study was to systematically review the current published peer-reviewed literature on robotic-assisted laparoscopic sacrocolpopexy with greater than six-month anatomic outcome data.
Studies were selected after applying predetermined inclusion and exclusion criteria to a MEDLINE search. Two independent reviewers blinded to each other’s results abstracted demographic data, perioperative information and postoperative outcomes. The primary outcome assessed was anatomic success rate defined as ≤POP-Q Stage 1. A random effects model was performed for meta-analysis of selected outcomes.
13 studies were selected for the systematic review. Meta-analysis yielded a combined estimated success rate of 98.6% (95%CI 97.0–100%). The combined estimated rate of mesh exposure/erosion was 4.1% (95%CI 1.4–6.9%), and the rate of reoperation for mesh revision was 1.7%. The rates of reoperation for recurrent apical and non-apical prolapse were 0.8% and 2.5% respectively. The most common surgical complication (excluding mesh erosion) was cystotomy (2.8%), followed by wound infection (2.4%).
The outcomes of this analysis indicate that robotic sacrocolpopexy is an effective surgical treatment for apical prolapse with high anatomic cure rate and low rate of complications.
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DOI: 10.1097/SPV.0000000000000070
PubMed: 25181374
PubMed Central: 4374352
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Outcomes of Robotic Sacrocolpopexy: A Systematic Review and Meta-analysis</title><author><name sortKey="Hudson, Catherine O" sort="Hudson, Catherine O" uniqKey="Hudson C" first="Catherine O." last="Hudson">Catherine O. Hudson</name><affiliation wicri:level="2"><nlm:aff id="A1">Division of Female Pelvic Medicine & Reconstructive Surgery, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia 30322</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Géorgie (États-Unis)</region></placeName><wicri:cityArea>Division of Female Pelvic Medicine & Reconstructive Surgery, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta</wicri:cityArea></affiliation></author><author><name sortKey="Northington, Gina M" sort="Northington, Gina M" uniqKey="Northington G" first="Gina M." last="Northington">Gina M. Northington</name><affiliation wicri:level="2"><nlm:aff id="A1">Division of Female Pelvic Medicine & Reconstructive Surgery, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia 30322</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Géorgie (États-Unis)</region></placeName><wicri:cityArea>Division of Female Pelvic Medicine & Reconstructive Surgery, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta</wicri:cityArea></affiliation></author><author><name sortKey="Lyles, Robert H" sort="Lyles, Robert H" uniqKey="Lyles R" first="Robert H." last="Lyles">Robert H. Lyles</name><affiliation wicri:level="2"><nlm:aff id="A2">Department of Biostatistics and Bioinformatics, Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA 30322</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Géorgie (États-Unis)</region></placeName><wicri:cityArea>Department of Biostatistics and Bioinformatics, Rollins School of Public Health, 1518 Clifton Road NE, Atlanta</wicri:cityArea></affiliation></author><author><name sortKey="Karp, Deborah R" sort="Karp, Deborah R" uniqKey="Karp D" first="Deborah R." last="Karp">Deborah R. Karp</name><affiliation wicri:level="2"><nlm:aff id="A1">Division of Female Pelvic Medicine & Reconstructive Surgery, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia 30322</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Géorgie (États-Unis)</region></placeName><wicri:cityArea>Division of Female Pelvic Medicine & Reconstructive Surgery, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta</wicri:cityArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25181374</idno><idno type="pmc">4374352</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4374352</idno><idno type="RBID">PMC:4374352</idno><idno type="doi">10.1097/SPV.0000000000000070</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">001843</idno><idno type="wicri:Area/Pmc/Curation">001843</idno><idno type="wicri:Area/Pmc/Checkpoint">000A51</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Outcomes of Robotic Sacrocolpopexy: A Systematic Review and Meta-analysis</title><author><name sortKey="Hudson, Catherine O" sort="Hudson, Catherine O" uniqKey="Hudson C" first="Catherine O." last="Hudson">Catherine O. Hudson</name><affiliation wicri:level="2"><nlm:aff id="A1">Division of Female Pelvic Medicine & Reconstructive Surgery, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia 30322</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Géorgie (États-Unis)</region></placeName><wicri:cityArea>Division of Female Pelvic Medicine & Reconstructive Surgery, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta</wicri:cityArea></affiliation></author><author><name sortKey="Northington, Gina M" sort="Northington, Gina M" uniqKey="Northington G" first="Gina M." last="Northington">Gina M. Northington</name><affiliation wicri:level="2"><nlm:aff id="A1">Division of Female Pelvic Medicine & Reconstructive Surgery, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia 30322</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Géorgie (États-Unis)</region></placeName><wicri:cityArea>Division of Female Pelvic Medicine & Reconstructive Surgery, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta</wicri:cityArea></affiliation></author><author><name sortKey="Lyles, Robert H" sort="Lyles, Robert H" uniqKey="Lyles R" first="Robert H." last="Lyles">Robert H. Lyles</name><affiliation wicri:level="2"><nlm:aff id="A2">Department of Biostatistics and Bioinformatics, Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA 30322</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Géorgie (États-Unis)</region></placeName><wicri:cityArea>Department of Biostatistics and Bioinformatics, Rollins School of Public Health, 1518 Clifton Road NE, Atlanta</wicri:cityArea></affiliation></author><author><name sortKey="Karp, Deborah R" sort="Karp, Deborah R" uniqKey="Karp D" first="Deborah R." last="Karp">Deborah R. Karp</name><affiliation wicri:level="2"><nlm:aff id="A1">Division of Female Pelvic Medicine & Reconstructive Surgery, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia 30322</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Géorgie (États-Unis)</region></placeName><wicri:cityArea>Division of Female Pelvic Medicine & Reconstructive Surgery, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta</wicri:cityArea></affiliation></author></analytic><series><title level="j">Female pelvic medicine & reconstructive surgery</title><idno type="ISSN">2151-8378</idno><idno type="eISSN">2154-4212</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objectives</title><p id="P1">Robotic sacrocolpopexy has been rapidly incorporated into surgical practice without comprehensive and systematically published outcome data. The aim of this study was to systematically review the current published peer-reviewed literature on robotic-assisted laparoscopic sacrocolpopexy with greater than six-month anatomic outcome data.</p></sec><sec id="S2"><title>Methods</title><p id="P2">Studies were selected after applying predetermined inclusion and exclusion criteria to a MEDLINE search. Two independent reviewers blinded to each other’s results abstracted demographic data, perioperative information and postoperative outcomes. The primary outcome assessed was anatomic success rate defined as ≤POP-Q Stage 1. A random effects model was performed for meta-analysis of selected outcomes.</p></sec><sec id="S3"><title>Results</title><p id="P3">13 studies were selected for the systematic review. Meta-analysis yielded a combined estimated success rate of 98.6% (95%CI 97.0–100%). The combined estimated rate of mesh exposure/erosion was 4.1% (95%CI 1.4–6.9%), and the rate of reoperation for mesh revision was 1.7%. The rates of reoperation for recurrent apical and non-apical prolapse were 0.8% and 2.5% respectively. The most common surgical complication (excluding mesh erosion) was cystotomy (2.8%), followed by wound infection (2.4%).</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">The outcomes of this analysis indicate that robotic sacrocolpopexy is an effective surgical treatment for apical prolapse with high anatomic cure rate and low rate of complications.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">101528690</journal-id><journal-id journal-id-type="pubmed-jr-id">38508</journal-id><journal-id journal-id-type="nlm-ta">Female Pelvic Med Reconstr Surg</journal-id><journal-id journal-id-type="iso-abbrev">Female Pelvic Med Reconstr Surg</journal-id><journal-title-group><journal-title>Female pelvic medicine & reconstructive surgery</journal-title></journal-title-group><issn pub-type="ppub">2151-8378</issn><issn pub-type="epub">2154-4212</issn></journal-meta><article-meta><article-id pub-id-type="pmid">25181374</article-id><article-id pub-id-type="pmc">4374352</article-id><article-id pub-id-type="doi">10.1097/SPV.0000000000000070</article-id><article-id pub-id-type="manuscript">NIHMS666066</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Outcomes of Robotic Sacrocolpopexy: A Systematic Review and Meta-analysis</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Hudson</surname><given-names>Catherine O.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Northington</surname><given-names>Gina M.</given-names></name><degrees>MD PHD</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Lyles</surname><given-names>Robert H.</given-names></name><degrees>PHD</degrees><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Karp</surname><given-names>Deborah R.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A1">1</xref></contrib></contrib-group><aff id="A1"><label>1</label>Division of Female Pelvic Medicine & Reconstructive Surgery, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia 30322</aff><aff id="A2"><label>2</label>Department of Biostatistics and Bioinformatics, Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA 30322</aff><author-notes><corresp id="cor1">Corresponding Author: Deborah R. Karp, MD, Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology and Obstetrics, Emory University School of Medicine, Woodruff Memorial Research Building, 1639 Pierce Drive, Room 4305, Atlanta, Georgia 30322, Tel 404.727-8600, Fax 404.727.8609, <email>debby.karp@emory.edu</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>25</day><month>2</month><year>2015</year></pub-date><pub-date pub-type="ppub"><season>Sep-Oct</season><year>2014</year></pub-date><pub-date pub-type="pmc-release"><day>26</day><month>3</month><year>2015</year></pub-date><volume>20</volume><issue>5</issue><fpage>252</fpage><lpage>260</lpage><pmc-comment>elocation-id from pubmed: 10.1097/SPV.0000000000000070</pmc-comment>
<abstract><sec id="S1"><title>Objectives</title><p id="P1">Robotic sacrocolpopexy has been rapidly incorporated into surgical practice without comprehensive and systematically published outcome data. The aim of this study was to systematically review the current published peer-reviewed literature on robotic-assisted laparoscopic sacrocolpopexy with greater than six-month anatomic outcome data.</p></sec><sec id="S2"><title>Methods</title><p id="P2">Studies were selected after applying predetermined inclusion and exclusion criteria to a MEDLINE search. Two independent reviewers blinded to each other’s results abstracted demographic data, perioperative information and postoperative outcomes. The primary outcome assessed was anatomic success rate defined as ≤POP-Q Stage 1. A random effects model was performed for meta-analysis of selected outcomes.</p></sec><sec id="S3"><title>Results</title><p id="P3">13 studies were selected for the systematic review. Meta-analysis yielded a combined estimated success rate of 98.6% (95%CI 97.0–100%). The combined estimated rate of mesh exposure/erosion was 4.1% (95%CI 1.4–6.9%), and the rate of reoperation for mesh revision was 1.7%. The rates of reoperation for recurrent apical and non-apical prolapse were 0.8% and 2.5% respectively. The most common surgical complication (excluding mesh erosion) was cystotomy (2.8%), followed by wound infection (2.4%).</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">The outcomes of this analysis indicate that robotic sacrocolpopexy is an effective surgical treatment for apical prolapse with high anatomic cure rate and low rate of complications.</p></sec></abstract><kwd-group><kwd>sacrocolpopexy</kwd><kwd>robotics</kwd><kwd>pelvic organ prolapse</kwd><kwd>mesh erosion</kwd></kwd-group></article-meta></front></pmc><affiliations><list><country><li>États-Unis</li></country><region><li>Géorgie (États-Unis)</li></region></list><tree><country name="États-Unis"><region name="Géorgie (États-Unis)"><name sortKey="Hudson, Catherine O" sort="Hudson, Catherine O" uniqKey="Hudson C" first="Catherine O." last="Hudson">Catherine O. Hudson</name></region><name sortKey="Karp, Deborah R" sort="Karp, Deborah R" uniqKey="Karp D" first="Deborah R." last="Karp">Deborah R. Karp</name><name sortKey="Lyles, Robert H" sort="Lyles, Robert H" uniqKey="Lyles R" first="Robert H." last="Lyles">Robert H. Lyles</name><name sortKey="Northington, Gina M" sort="Northington, Gina M" uniqKey="Northington G" first="Gina M." last="Northington">Gina M. Northington</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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