Universität zu Köln

Rudroff, Claudia ORCID: 0000-0003-3347-0108, Madukkakuzhy, Joshy ORCID: 0009-0004-5917-3560, Hernandez, Alberto Vega ORCID: 0000-0003-0971-5400, Otten, Jakob, Ulrici, Christoph, Karapanos, Leonidas ORCID: 0000-0001-7608-7673 and Ludwig, Sebastian ORCID: 0000-0002-2503-7884 (2024). Early safety and efficiency outcomes of a novel interdisciplinary laparoscopic resection rectopexy combined with sacrocolpopexy for women with obstructive defecation syndrome and pelvic organ prolapse: a single center study. BMC Surgery, 24 (1). pp. 1-13. Springer Nature. ISSN 1471-2482

PDF s12893-024-02474-4.pdf Bereitstellung unter der CC-Lizenz: Creative Commons Attribution. Download (1MB)

Abstract

[Artikel-Nr.: 185] Background: Obstructive defecation syndrome (ODS) defines a disturbed defecation process frequently associated with pelvic organ prolapse (POP) in women that substantially compromises quality of life. Conservative management offers limited relief and a surgical intervention may be required. This is characterized by individual approaches. Aim of the study: This retrospective single center study evaluated the surgical and clinical short-term outcome of a novel interdisciplinary laparoscopic resection rectopexy (L-RRP) with mesh- sacrocolpopexy (L-SCP) for women suffering from ODS and POP. Methods: The study participants underwent surgery in an interdisciplinary laparoscopic approach. Safety was the primary endpoint, assessed via postoperative morbidity classified by Clavien-Dindo scale. Secondary outcomes included evaluation of bowel function, fecal and urinary incontinence and pelvic organ prolapse status at 12 months follow-up. Additionally, a biological mesh (BM) was offered to women, who asked for an alternative to synthetic mesh material (SM). Results: Of the 44 consecutive patients requiring surgery for ODS and POP, 36 patients underwent the interdisciplinary surgical approach; 28 patients with SM and 8 patients with BM. In total 5 complications occurred, four of them were classified as minor. One minor complication was observed in the BM group. One anastomotic leakage occurred in the SM group. The two ODS scores, the bowel dysfunction score, and the incontinence score improved significantly ( p = 0.006, p = 0.003, p < 0.001, and p = 0.0035, respectively). Pelvic floor anatomy was fully restored (POP-Q 0) for 29 (80%) patients after surgery. 17 patients (47%) suffered from urinary incontinence before surgery, which was restored in 13 patients (76.5%). Conclusions: The interdisciplinary approach with L-RRP and L-SCP and the use of a BM in a small subgroup were technically feasible, safe, and effective in this single center setting. The study’s retrospective design, the small sample size and the lack of comparators limit the generalizability of the findings requiring future randomized trials. Trial registration: Retrospectively registered at clinicaltrials.gov, trial number NCT05910021, date of registration 06/10/2023.

Item Type:	Article
Creators:	Creators Email ORCID ORCID Put Code Rudroff, Claudia UNSPECIFIED https://orcid.org/0000-0003-3347-0108 UNSPECIFIED Madukkakuzhy, Joshy UNSPECIFIED https://orcid.org/0009-0004-5917-3560 UNSPECIFIED Hernandez, Alberto Vega UNSPECIFIED https://orcid.org/0000-0003-0971-5400 UNSPECIFIED Otten, Jakob UNSPECIFIED UNSPECIFIED UNSPECIFIED Ulrici, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Karapanos, Leonidas UNSPECIFIED https://orcid.org/0000-0001-7608-7673 UNSPECIFIED Ludwig, Sebastian UNSPECIFIED https://orcid.org/0000-0002-2503-7884 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-815679
Identification Number:	10.1186/s12893-024-02474-4
Journal or Publication Title:	BMC Surgery
Volume:	24
Number:	1
Page Range:	pp. 1-13
Number of Pages:	13
Date:	14 June 2024
Publisher:	Springer Nature
ISSN:	1471-2482
Language:	English
Faculty:	External institution Faculty of Medicine
Divisions:	Faculty of Medicine > Frauenheilkunde > Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe Faculty of Medicine > Urologie > Klinik und Poliklinik für Urologie
Subjects:	Medical sciences Medicine
Uncontrolled Keywords:	Keywords Language fecation syndrome ; Pelvic organ prolapse ; Resection rectopexy ; Sacrocolpopexy ; Synthetic mesh ; Biological mesh English
['eprint_fieldname_oa_funders' not defined]:	Publikationsfonds UzK
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/81567