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Simoncini T, Panattoni A, Cadenbach-Blome T, Caiazzo N, García MC, Caretto M, Chun F, Francescangeli E, Gaia G, Giannini A, Hegenscheid L, Luisi S, Mannella P, Mereu L, Montt-Guevara MM, Ñiguez I, Ritter R, Russo E, Ferrer MLS, Tammaa A, Uhl B, Wiedemann B, Wilczak M, Pauli F, Dubuisson J. Role of lateral suspension for the treatment of pelvic organ prolapse: a Delphi survey of expert panel. Surg Endosc 2024; 38:4344-4352. [PMID: 38877319 PMCID: PMC11289001 DOI: 10.1007/s00464-024-10917-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 05/05/2024] [Indexed: 06/16/2024]
Abstract
INTRODUCTION AND HYPOTHESIS Lateral suspension is an abdominal prosthetic surgical procedure used to correct apical prolapse. The procedure involves the placement of a T-shaped mesh on the anterior vaginal wall and on the isthmus or uterine cervix that is suspended laterally and posteriorly to the abdominal wall. Since its description in the late 90s, modifications of the technique have been described. So far, no consensus on the correct indications, safety, advantages, and disadvantages of this emerging procedure has been reached. METHODS A modified Delphi process was used to build consensus within a group of 21 international surgeons who are experts in the performance of laparoscopic lateral suspension (LLS). The process was held with a first online round, where the experts expressed their level of agreement on 64 statements on indications, technical features, and other aspects of LLS. A subsequent re-discussion of statements where a threshold of agreement was not reached was held in presence. RESULTS The Delphi process allowed the identification of several aspects of LLS that represented areas of agreement by the experts. The experts agreed that LLS is a safe and effective technique to correct apical and anterior prolapse. The experts highlighted several key technical aspects of the procedure, including clinical indications and surgical steps. CONCLUSIONS This Delphi consensus provides valuable guidance and criteria for the use of LLS in the treatment of pelvic organ prolapse, based on expert opinion by large volume surgeons' experts in the performance of this innovative procedure.
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Affiliation(s)
- Tommaso Simoncini
- Division of Obstetrics and Gynecology, Department of Clinical and Reproductive Medicine, University of Pisa, via Roma 67, 56126, Pisa, Italy.
| | - Andrea Panattoni
- AOU Pisana: Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | | | - Nicola Caiazzo
- Division of Obstetrics and Gynecology, Ospedale Giovanni Battista Grassi di Ostia, Azienda ASL Roma 3, Rome, Italy
| | - Maribel Calero García
- Division of Obstetrics and Gynecology, Hospital Materno-Infantil Quirónsalud, Seville, Spain
| | - Marta Caretto
- Division of Obstetrics and Gynecology, Department of Clinical and Reproductive Medicine, University of Pisa, via Roma 67, 56126, Pisa, Italy
| | - Fu Chun
- Department of Obstetrics and Gynecology, The Second Xiangya Hospital Central South University, Changsha, Hunan, China
| | - Eric Francescangeli
- Division of Obstetrics and Gynecology, Istituto Clinico Sant'Anna, Brescia, Italy
| | - Giorgia Gaia
- Department of Gynecology, ASST Santi Paolo e Carlo, Milan, Italy
| | - Andrea Giannini
- Division of Obstetrics and Gynecology, Department of Clinical and Reproductive Medicine, University of Pisa, via Roma 67, 56126, Pisa, Italy
| | - Lucas Hegenscheid
- Division of Obstetrics and Gynecology, Medizinische Hochschule Brandenburg - Immanuelklinik Rüdersdorf, Berlin, Germany
| | - Stefano Luisi
- Division of Obstetrics and Gynecology, Department of Clinical and Reproductive Medicine, University of Pisa, via Roma 67, 56126, Pisa, Italy
| | - Paolo Mannella
- Division of Obstetrics and Gynecology, Department of Clinical and Reproductive Medicine, University of Pisa, via Roma 67, 56126, Pisa, Italy
| | - Liliana Mereu
- Division of Obstetrics and Gynecology, CHIRMED Department, G. Rodolico Hospital, University of Catania, Catania, Italy
| | - Maria Magdalena Montt-Guevara
- Division of Obstetrics and Gynecology, Department of Clinical and Reproductive Medicine, University of Pisa, via Roma 67, 56126, Pisa, Italy
| | - Isabel Ñiguez
- Department of Obstetrics and Gynecology, Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain
| | | | - Eleonora Russo
- AOU Pisana: Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Maria Luisa Sanchez Ferrer
- Department of Obstetrics and Gynecology, Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain
| | - Ayman Tammaa
- Department of Obstetrics and Gynecology, Wilhelminen Hospital, Vienna, Austria
| | - Bernhard Uhl
- Evangelisches Krankenhaus Oberhausen, Wesel, Germany
| | | | - Maciej Wilczak
- Department of Medical Education, University of Medical Sciences, Poznan, Poland
| | - Friedrich Pauli
- Department of Obstetrics and Gynecology, University Hospital Augsburg, Augsburg, Germany
| | - Jean Dubuisson
- Department of Obstetrics and Gynecology, Geneva University Hospitals, Geneva, Switzerland
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Ferrari A, Seghieri C, Giannini A, Mannella P, Simoncini T, Vainieri M. Driving time drives the hospital choice: choice models for pelvic organ prolapse surgery in Italy. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2023; 24:1575-1586. [PMID: 36630004 PMCID: PMC9833017 DOI: 10.1007/s10198-022-01563-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE The Italian healthcare jurisdiction promotes patient mobility, which is a major determinant of practice variation, thus being related to the equity of access to health services. We aimed to explore how travel times, waiting times, and other efficiency- and quality-related hospital attributes influenced the hospital choice of women needing pelvic organ prolapse (POP) surgery in Tuscany, Italy. METHODS We obtained the study population from Hospital Discharge Records. We duplicated individual observations (n = 2533) for the number of Tuscan hospitals that provided more than 30 POP interventions from 2017 to 2019 (n = 22) and merged them with the hospitals' list. We generated the dichotomous variable "hospital choice" assuming the value one when hospitals where patients underwent surgery coincided with one of the 22 hospitals. We performed mixed logit models to explore between-hospital patient choice, gradually adding the women's features as interactions. RESULTS Patient choice was influenced by travel more than waiting times. A general preference for hospitals delivering higher volumes of interventions emerged. Interaction analyses showed that poorly educated women were less likely to choose distant hospitals and hospitals providing greater volumes of interventions compared to their counterpart. Women with multiple comorbidities more frequently chose hospitals with shorter average length of stay. CONCLUSION Travel times were the main determinants of hospital choice. Other quality- and efficiency-related hospital attributes influenced hospital choice as well. However, the effect depended on the socioeconomic and clinical background of women. Managers and policymakers should consider these findings to understand how women behave in choosing providers and thus mitigate equity gaps.
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Affiliation(s)
- Amerigo Ferrari
- Institute of Management, MeS (Management and Health) Laboratory, Sant'Anna School of Advanced Studies, Via San Zeno 2, 56127, Pisa, Italy.
| | - Chiara Seghieri
- Institute of Management, MeS (Management and Health) Laboratory, Sant'Anna School of Advanced Studies, Via San Zeno 2, 56127, Pisa, Italy
| | - Andrea Giannini
- Department of Clinical and Experimental Medicine, Division of Obstetrics and Gynaecology, University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | - Paolo Mannella
- Department of Clinical and Experimental Medicine, Division of Obstetrics and Gynaecology, University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | - Tommaso Simoncini
- Department of Clinical and Experimental Medicine, Division of Obstetrics and Gynaecology, University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | - Milena Vainieri
- Institute of Management, MeS (Management and Health) Laboratory, Sant'Anna School of Advanced Studies, Via San Zeno 2, 56127, Pisa, Italy
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Simoncini T, Panattoni A, Aktas M, Ampe J, Betschart C, Bloemendaal ALA, Buse S, Campagna G, Caretto M, Cervigni M, Consten ECJ, Davila HH, Dubuisson J, Espin-Basany E, Fabiani B, Faucheron JL, Giannini A, Gurland B, Hahnloser D, Joukhadar R, Mannella P, Mereu L, Martellucci J, Meurette G, Montt Guevara MM, Ratto C, O'Reilly BA, Reisenauer C, Russo E, Schraffordt Koops S, Siddiqi S, Sturiale A, Naldini G. Robot-assisted pelvic floor reconstructive surgery: an international Delphi study of expert users. Surg Endosc 2023:10.1007/s00464-023-10001-4. [PMID: 36952046 PMCID: PMC10035464 DOI: 10.1007/s00464-023-10001-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 02/25/2023] [Indexed: 03/24/2023]
Abstract
BACKGROUND Robotic surgery has gained popularity for the reconstruction of pelvic floor defects. Nonetheless, there is no evidence that robot-assisted reconstructive surgery is either appropriate or superior to standard laparoscopy for the performance of pelvic floor reconstructive procedures or that it is sustainable. The aim of this project was to address the proper role of robotic pelvic floor reconstructive procedures using expert opinion. METHODS We set up an international, multidisciplinary group of 26 experts to participate in a Delphi process on robotics as applied to pelvic floor reconstructive surgery. The group comprised urogynecologists, urologists, and colorectal surgeons with long-term experience in the performance of pelvic floor reconstructive procedures and with the use of the robot, who were identified primarily based on peer-reviewed publications. Two rounds of the Delphi process were conducted. The first included 63 statements pertaining to surgeons' characteristics, general questions, indications, surgical technique, and future-oriented questions. A second round including 20 statements was used to reassess those statements where borderline agreement was obtained during the first round. The final step consisted of a face-to-face meeting with all participants to present and discuss the results of the analysis. RESULTS The 26 experts agreed that robotics is a suitable indication for pelvic floor reconstructive surgery because of the significant technical advantages that it confers relative to standard laparoscopy. Experts considered these advantages particularly important for the execution of complex reconstructive procedures, although the benefits can be found also during less challenging cases. The experts considered the robot safe and effective for pelvic floor reconstruction and generally thought that the additional costs are offset by the increased surgical efficacy. CONCLUSION Robotics is a suitable choice for pelvic reconstruction, but this Delphi initiative calls for more research to objectively assess the specific settings where robotic surgery would provide the most benefit.
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Affiliation(s)
- Tommaso Simoncini
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
| | - Andrea Panattoni
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Mustafa Aktas
- Division of Obstetrics and Gynecology, Maasstad Hospital, Rotterdam, The Netherlands
| | - Jozef Ampe
- Department of Urology, AZ Sint-Jan Bruges Hospitals, Brugge, Belgium
| | - Cornelia Betschart
- Department of Gynecology, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
| | | | - Stephan Buse
- Department of Urology and Urologic Oncology, Alfried Krupp Hospital, Essen, Germany
| | - Giuseppe Campagna
- Division of Urogynecology and Pelvic Floor Reconstructive Surgery, Department of Women and Child Health, University Hospital A. Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy
| | - Marta Caretto
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Mauro Cervigni
- Department of Urology, La Sapienza University-Polo Pontino ICOT, Latina, Italy
| | - Esther C J Consten
- Department of Surgery, Meander Medical Center, Amersfoort and Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands
| | - Hugo H Davila
- Cleveland Clinic Indian River Hospital, Florida State University, College of Medicine, Tallahassee, FL, USA
| | - Jean Dubuisson
- Department of Pediatrics, Gynecology, and Obstetrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Eloy Espin-Basany
- Unidad de Cirugía Colorrectal, Servicio de Cirugía General, Hospital Valle de Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Bernardina Fabiani
- Proctology and Pelvic Floor Clinical Center, Cisanello University Hospital, Pisa, Italy
| | - Jean-Luc Faucheron
- Colorectal Surgery Unit, Visceral Surgery and Acute Care Surgery Department, Grenoble Alps University Hospital, Grenoble, France
| | - Andrea Giannini
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Brooke Gurland
- Division of Colorectal Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Dieter Hahnloser
- Department of Visceral Surgery, University Hospital Lausanne, Lausanne, Switzerland
| | - Ralf Joukhadar
- Department of Obstetrics and Gynecology, University of Wuerzburg, Würzburg, Germany
| | - Paolo Mannella
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Liliana Mereu
- Department of Obstetrics and Gynecology, Cannizzaro Hospital, Catania, Italy
| | - Jacopo Martellucci
- Department of General, Emergency and Minimally Invasive Surgery, Careggi University Hospital, Florence, Italy
| | - Guillaume Meurette
- Digestive and Endocrine Surgery Clinic, IMAD, CHU de Nantes, Hôtel Dieu, Nantes Cedex, France
| | - Maria Magdalena Montt Guevara
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Carlo Ratto
- Proctology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Barry A O'Reilly
- Department of Obstetrics and Gynecology, Cork University Maternity Hospital, Cork, Ireland
| | - Christl Reisenauer
- Department of Obstetrics and Gynecology, University Hospital Tuebingen, Tuebingen, Germany
| | - Eleonora Russo
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | | | - Alessandro Sturiale
- Proctology and Pelvic Floor Clinical Center, Cisanello University Hospital, Pisa, Italy
| | - Gabriele Naldini
- Proctology and Pelvic Floor Clinical Center, Cisanello University Hospital, Pisa, Italy
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Ferrari A, Giannini A, Seghieri C, Simoncini T, Vainieri M. Regional practice variation in pelvic organ prolapse surgery in Tuscany, Italy: a retrospective cohort study on administrative health data. BMJ Open 2023; 13:e068145. [PMID: 36882257 PMCID: PMC10008403 DOI: 10.1136/bmjopen-2022-068145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
OBJECTIVES To explore determinants of practice variation in both access, and quality and efficiency of surgical care for pelvic organ prolapse (POP). DESIGN AND SETTING A retrospective cohort study employing administrative health data from the Tuscany region, Italy. PARTICIPANTS All women over 40 years hospitalised for apical/multicompartmental POP reconstructive surgery (excluding anterior/posterior colporrhaphy without concomitant hysterectomy) from January 2017 to December 2019. OUTCOMES We first computed treatment rates just for women residing in Tuscany (n=2819) and calculated the Systematic Component of Variation (SCV) to explore variation in access to care among health districts. Then, using the full cohort (n=2959), we ran multilevel models for the average length of stay and reoperations, readmissions and complications, and computed the intraclass correlation coefficient to assess the individual and hospital determinants of efficiency and quality of care provided by hospitals. RESULTS The 5.4-fold variation between the lowest-rate (56/100 000 inhabitants) and the highest-rate (302/100 000) districts and the SCV over 10% confirmed high systematic variation in the access to care. Higher treatment rates were driven by greater provisions of robotic and/or laparoscopic interventions, which showed highly variable usage rates. Both individual and hospital factors influenced quality and efficiency provided by hospitals, but just low proportions of variation were explained by hospital and patient characteristics. CONCLUSIONS We found high and systematic variation in the access to POP surgical care in Tuscany and in quality and efficiency provided by hospitals. Such a variation may be mainly explained by user and provider preferences, which should be further explored. Also, supply-side factors may be involved, suggesting that wider and more uniform dissemination of robotic/laparoscopic procedures may reduce variation.
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Affiliation(s)
- Amerigo Ferrari
- Institute of Management, MeS (Management and Health) Laboratory, Sant'Anna School of Advanced Studies, Pisa, Italy
| | - Andrea Giannini
- Department of Clinical and Experimental Medicine, Division of Obstetrics and Gynaecology, University of Pisa, Pisa, Italy
| | - Chiara Seghieri
- Institute of Management, MeS (Management and Health) Laboratory, Sant'Anna School of Advanced Studies, Pisa, Italy
| | - Tommaso Simoncini
- Department of Clinical and Experimental Medicine, Division of Obstetrics and Gynaecology, University of Pisa, Pisa, Italy
| | - Milena Vainieri
- Institute of Management, MeS (Management and Health) Laboratory, Sant'Anna School of Advanced Studies, Pisa, Italy
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Zhou Q, Lu M, Li GS, Peng GL, Song YF. Knowledge mapping and visualization analysis of pelvic organ prolapse repair with mesh from 2001 to 2021. Front Bioeng Biotechnol 2023; 11:1104724. [PMID: 37091336 PMCID: PMC10113510 DOI: 10.3389/fbioe.2023.1104724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 03/22/2023] [Indexed: 04/25/2023] Open
Abstract
Aims: In recent decades, extensive attention has been paid to the application of mesh to repair pelvic floor defects. However, a large body of related literature has not been system summarized. The purpose of this study is to summarize and visualize the literature on pelvic organ prolapse (POP) repair with mesh using bibliometrics. Methods: Medical literature regarding POP repair with mesh were searched and obtained in the Web of Science™ Core (WoSCC) database from 2001 to 2021. Microsoft Excel 2020, CiteSpace and VOSviewer were used to conduct the bibliometric and knowledge-map analysis. Results: In the past 20 years, a total of 2,550 articles and reviews have been published in 35 journals, and the published and cited results show a growing trend. Cosson M and International Urogynecology Journal were the authors and journals with the highest output, respectively. The United States, France and the United Kingdom are among the top three countries/organizations in relevant publications in worldwide. 584 key words in the literature are divided into 8 clusters, which are mainly related to prolapse type, risk factors, surgical methods, imaging, quality of life and bioengineering. Using clinical research and tissue engineering technology to reduce mesh complications is the current hot spot in this field. Conclusion: Reasonable application of mesh and avoiding mesh complications are still the most concerned topics in POP research. Although clinical research, surgical improvement, biological mesh and bioengineering technology have shown promising results, it is still urgent to carry out clinical transformation application research.
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Affiliation(s)
- Quan Zhou
- Department of Gynecology and Obstetrics, The People’s Hospital of China Three Gorges University/The First People’s Hospital of Yichang, Yichang, China
- Department of Gynecology and Obstetrics, The 900th Hospital of Joint Logistic Support Force, Fuzhou, Fujian, China
- *Correspondence: Quan Zhou, ; Yan-Feng Song,
| | - Man Lu
- Department of Gynecology and Obstetrics, The People’s Hospital of China Three Gorges University/The First People’s Hospital of Yichang, Yichang, China
| | - Guo-Sheng Li
- Department of Gynecology and Obstetrics, The People’s Hospital of China Three Gorges University/The First People’s Hospital of Yichang, Yichang, China
| | - Gan-Lu Peng
- Department of Gynecology and Obstetrics, The People’s Hospital of China Three Gorges University/The First People’s Hospital of Yichang, Yichang, China
| | - Yan-Feng Song
- Department of Gynecology and Obstetrics, The 900th Hospital of Joint Logistic Support Force, Fuzhou, Fujian, China
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Sharifiaghdas F. Autologous rectus fascia graft in the treatment of high-stage apical vaginal prolapse: preliminary results of a new surgical approach with native tissue. Int Urol Nephrol 2022; 54:1017-1022. [DOI: 10.1007/s11255-022-03167-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/26/2022] [Indexed: 10/18/2022]
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Wang L, Li CX, Tian Y, Ye JW, Li F, Tong WD. Abdominal ventral rectopexy with colectomy for obstructed defecation syndrome: An alternative option for selected patients. World J Clin Cases 2020; 8:5976-5987. [PMID: 33344596 PMCID: PMC7723726 DOI: 10.12998/wjcc.v8.i23.5976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/26/2020] [Accepted: 10/13/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Abdominal ventral rectopexy (AVR) with colectomy is controversial in the treatment of obstructed defecation syndrome (ODS). Literature data on this technique for ODS are very limited.
AIM To evaluate the safety and efficacy of AVR with colectomy for selected patients with ODS.
METHODS Consecutive patients who underwent AVR with colectomy for ODS were identified prospectively from 2016 to 2017 in our department. Patient demographics, perioperative surgical results, and postoperative follow-up outcomes were collected and analyzed. Long-term follow-up was evaluated with standardized questionnaires. The severity of symptoms was assessed by the objective Wexner Constipation Score (WCS) and ODS Score. The quality of life was assessed by the Patients Assessment of Constipation Quality of Life score. Functional outcome was compared pre- and post-operatively for each patient. The primary outcomes were determined by the improvement in symptoms and quality of life. Secondary outcome measures were operating time, postoperative length of stay, morbidity and mortality, improvement of pelvic floor structure, and patient satisfaction.
RESULTS Four patients underwent robotic-assisted surgery, and two patients underwent a laparoscopic-assisted procedure. The mean operating time for the robotic approach was 243 min (range 160–300 min), and the mean operating time for the laparoscopic approach was 230 min (range 220-240 min). The mean postoperative length of stay was 8.2 d (range 6-12 d). There was no conversion to open procedure and no postoperative mortality. No urinary retention, wound infection, prolonged ileus, pelvic infection and anastomosis leakage occurred. Six patients were followed up for 36 mo. The WCS, ODS, and Patients Assessment of Constipation Quality of Life score improved significantly postoperatively (P < 0.05). The WCS and ODS scores showed the best remission and stabilization at 6 to 12 mo after surgery. There was no recurrence or novel constipation after surgery. None of the patients used laxative medication.
CONCLUSION Robotic and laparoscopic-assisted ventral rectopexy with colectomy is a safe and effective procedure for selected patients with ODS. However, comprehensive preoperative evaluation and careful patient selection are essential.
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Affiliation(s)
- Li Wang
- Department of General Surgery, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - Chun-Xue Li
- Department of General Surgery, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - Yue Tian
- Department of General Surgery, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - Jing-Wang Ye
- Department of General Surgery, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - Fan Li
- Department of General Surgery, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - Wei-Dong Tong
- Department of General Surgery, Daping Hospital, Army Medical University, Chongqing 400042, China
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Wang L, Li CX, Tian Y, Ye JW, Li F, Tong WD. Abdominal ventral rectopexy with colectomy for obstructed defecation syndrome: An alternative option for selected patients. World J Clin Cases 2020. [DOI: 10.12998/wjcc.v8.i23.5973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
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