Nerve preserving vs standard laparoscopic sacropexy: Postoperative bowel function

• 作者: Chiara Benedetto Paolo Petruzzelli Saverio Danese Stefano Cosma
• 来源期刊: 世界胃肠内镜杂志：英文版（电子版）
• 学科: 医学
• 关键词: 顶端的脱垂 肠机能障碍 Laparoscopic sacrocolpopexy 神经 sparing 阴道拱顶脱垂
• 年，卷（期）: 2017,（5）
• 页码范围: 211-219
• 页数: 9页
• 分类号: R574

摘要

AIM To compare our developed nerve preserving technique with the non-nerve preserving one in terms of de novo bowel symptoms.METHODS Patients affected by symptomatic apical prolapse, admitted to our department and treated by nerve preserving laparoscopic sacropexy(LSP) between October, 2010 and April, 2013(Group A or 'interventional group') were compared to those treated with the standard LSP, between September, 2007 and December, 2009(Group B or 'control group'). Functional and anatomical data were recorded prospectively at the first clinical review, at 1, 6 mo, and every postsurgical year. Questionnaires were filled in by the patients at each follow-up clinical evaluation.RESULTS Forty-three women were enrolled, 25/43 were treated by our nerve preserving technique and 18/43 by the standard one. The data from the interventional group were collected at a similar follow-up(> 18 mo) as those collected for the control group. No cases of de novo bowel dysfunction were observed in group A against 4 cases in group B(P = 0.02). Obstructed defecation syndrome(ODS) was highlighted by an increase in specific questionnaires scores and documented by the anorectal manometry. There were no cases of de novo constipation in the two groups. No major intraoperative complications were reported for our technique and it took no longer than the standard procedure. Apical recurrence and late complications were comparable in the two groups.CONCLUSION Our nerve preserving technique seems superior in terms of prevention of de novo bowel dysfunction compared to the standard one and had no major intraoperative complications.