دورية أكاديمية
Does variation of surgical technique affect native tissue anterior pelvic organ prolapse repair outcomes?
العنوان: | Does variation of surgical technique affect native tissue anterior pelvic organ prolapse repair outcomes? |
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المؤلفون: | Fairclough E; Warrell Unit, St Mary's Hospital, Manchester Foundation Trust, Oxford Road, Manchester, M13 9WL, UK.; Maternal & Fetal Health Research Centre, Manchester Academic Health Centre, University of Manchester, Manchester, M13 9WL, UK., Segar J; Institute of Population Health, University of Manchester, Oxford Road, Manchester, M13 9PL, UK., Breeman S; Health Services Research Unit, University of Aberdeen, 3rd Floor, Health Sciences Building, Foresterhill, Aberdeen, AB25 2ZD, UK., Smith A; Warrell Unit, St Mary's Hospital, Manchester Foundation Trust, Oxford Road, Manchester, M13 9WL, UK.; Maternal & Fetal Health Research Centre, Manchester Academic Health Centre, University of Manchester, Manchester, M13 9WL, UK., Myers J; Maternal & Fetal Health Research Centre, Manchester Academic Health Centre, University of Manchester, Manchester, M13 9WL, UK., Reid F; Warrell Unit, St Mary's Hospital, Manchester Foundation Trust, Oxford Road, Manchester, M13 9WL, UK. Fiona.Reid@mft.nhs.uk.; Maternal & Fetal Health Research Centre, Manchester Academic Health Centre, University of Manchester, Manchester, M13 9WL, UK. Fiona.Reid@mft.nhs.uk. |
المصدر: | International urogynecology journal [Int Urogynecol J] 2024 Jan; Vol. 35 (1), pp. 51-58. Date of Electronic Publication: 2023 Jul 21. |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Springer Country of Publication: England NLM ID: 101567041 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1433-3023 (Electronic) Linking ISSN: 09373462 NLM ISO Abbreviation: Int Urogynecol J Subsets: MEDLINE |
أسماء مطبوعة: | Original Publication: London : Springer |
مواضيع طبية MeSH: | Colpotomy*/methods , Pelvic Organ Prolapse*/surgery, Female ; Humans ; Surgeons ; Surgical Flaps ; Treatment Outcome ; Randomized Controlled Trials as Topic |
مستخلص: | Introduction and Hypothesis: The Variation in Surgical Technique study (VaST), demonstrated the large variation in surgical techniques used in native tissue (NT) anterior pelvic organ prolapse (POP) repairs. However, there are few comparative studies of different surgical techniques. This study was aimed at exploring whether surgical technique influenced the outcomes of NT anterior POP repairs. Methods: The surgical techniques of 22 consultant surgeons performing NT anterior POP repairs were filmed and categorised. These surgeons performed 809 anterior repairs within the PROlapse Surgery: Pragmatic Evaluation and randomised Controlled Trial (PROSPECT). Logistical regression models were used to determine the influence of the different surgical techniques on subjective and objective outcomes, using data collected during PROSPECT. Results: In adjusted multivariate linear regression models, fascial-flap repair was associated with an improved subjective outcome (POP-SS) compared with midline plication (β = -2.50 [-4.42 to -0.57]; p = 0.01). At 12 months, separate fascial defect repair was associated with a poorer objective outcome than midline plication (OR 6.06 [1.82-3.52], p = 0.006). At 24 months, deep dissection was associated with a poorer POP-SS than superficial dissection (0.32-2.60, p = 0.0). Continuous-locking closure of the skin was also associated with improved POP-SS compared with continuous non-locking closure (12 months: β = -1.94 [-3.42 to -0.45], p = 0.01). Conclusion: Surgical technique may influence the outcome of native tissue anterior POP repairs. Our results should not change practice but inform future research; to develop methods of explicitly recording surgical techniques and allow confirmation of the effect of these aspects of technique on outcome. (© 2023. The Author(s).) |
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فهرسة مساهمة: | Keywords: Native tissue; Outcome; Pelvic organ prolapse; Technique |
تواريخ الأحداث: | Date Created: 20230721 Date Completed: 20240205 Latest Revision: 20240210 |
رمز التحديث: | 20240210 |
مُعرف محوري في PubMed: | PMC10811059 |
DOI: | 10.1007/s00192-023-05584-4 |
PMID: | 37477667 |
قاعدة البيانات: | MEDLINE |
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