Comparison of laparoscopic techniques for apical organ prolapse repair – A systematic review of the literature
Neurourology and Urodynamics Sep 05, 2019
Szymczak P, et al. - A total of 1,002 papers were initially recognized by the researchers in order to examine methods of laparoscopic repair of the apical defect and contrast them with other techniques (open, vaginal, and robotic). Twenty-four studies completed the inclusion criteria. Four main laparoscopic procedures were observed. With patient satisfaction for pectopexy, laparoscopic sacropexy (LS), lateral ligament suspension and laparoscopic uterosacral ligament suspension (LUSLS) of 96.4% to 97.6%, 71.0% to 100%, 66.7% to 87.8%, and 95% to 95.5%, respectively, the reported anatomical success rate (POP-Q < II stage) was 77% to 100%. Prolapse recurrences following LUSLS and LS were reported in 13.2% and 10.4% of patients, respectively along with the reoperation rate for LS as 2.2% to 12.8%. Major complications involved hemorrhage, bladder, ureter, and/or bowel injuries were rare. Most studies informed anatomical and subjective outcomes, with follow-up ranging from 1 month to > 7 years. For laparoscopic and abdominal corrections of the apical defect, success rates were comparable and in terms of perioperative blood loss, length of hospital stay, and recovery, laparoscopy was better.
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