Complicaciones postoperatorias tempranas de la colporrafia anterior por técnica tradicional versus técnica de sitio específico


Autoria(s): García Riaño, Diego Armando; Aragón Mendoza, Rafael
Contribuinte(s)

Garzón Pulido, Lina Soledad

Data(s)

21/11/2012

Resumo

El prolapso del piso pélvico es una entidad frecuente, especialmente en pacientes postmenopáusicas y en su gran mayoría requiere tratamiento quirúrgico. En este estudio comparamos la aparición de complicaciones postoperatorias tempranas entre la colporrafia anterior con técnica clásica (TC) versus la colporrafia anterior con técnica de sitio especifico (CSE). Se realizó un estudio observacional analítico, retrospectivo, de dos cohortes de pacientes que requirieron colporrafia anterior entre agosto de 2009 hasta junio de 2012. Las características de cada grupo fueron homogéneas y comparables. El desenlace de mayor frecuencia fue dehiscencia de la línea de sutura, sin embargo, no se encontraron diferencias estadísticamente significativas entre las dos técnicas. La aparición de reprolapso temprano y el diagnóstico de abscesos o hematomas presentaron frecuencias que carecen de diferencia significativa. No hubo complicaciones tempranas graves tales como sangrado intraoperatoria mayor o lesiones vesicouretrales. Los resultados sugieren que las dos técnicas tienen una incidencia baja de complicaciones postoperatorias tempranas y por lo tanto parecen ser seguros dentro del manejo quirúrgico del prolapso del componente anterior del piso pélvico.

Organ pelvic prolapse is a frequent pathology, especially in menopausic patients and most cases require surgical treatment. In this study we compared the incidence of early postoperative complications between anterior colporrhaphy by classical technique (TC) versus anterior colporrhaphy by site specific technique (CSE). We made a analytical, retrospective study of two cohorts of patients that required anterior colporrhaphy between august 2009 and june 2012. The first cohort was TC group and the second was CSE group. The baseline characteristics of both groups were similar and comparable. The most frequent outcome was dehiscence; however, there was a difference without statistical significance between both techniques. The incidence of early new prolapse and the diagnosis of abscess or hematomes showed no statistical difference as well. There were not serious complications such as mayor intraoperative bleeding or bladder-urethral lesions. The results suggest that both techniques haw low incidence of early postoperative complications and therefore seem to be safe in management of anterior compartment pelvic prolapse.

Formato

application/pdf

Identificador

http://repository.urosario.edu.co/handle/10336/4006

Idioma(s)

spa

Publicador

Facultad de Medicina

Direitos

info:eu-repo/semantics/openAccess

Fonte

instname:Universidad del Rosario

reponame:Repositorio Institucional EdocUR

Walker JA, Gunasekera P. Pelvic organ prolapse and incontinence in developing countries: review of prevalence and risk factors. Int Urogynecol 2011; 22:127–135.

Slieker-ten Hove MCPh, Pool-Goudzwaard AL, Eijkemans MJC, et al. Symptomatic pelvic organ prolapse and possible risk factors in a general population. Am J Obstet Gynecol 2009; 200:184.e1-184.e7.

Seo JT, Kim JM. Pelvic organ support and prevalence by pelvic organ prolapse-quantification (POP-Q) in Korean women. J Urol. 2006; 175: 1769–177.

Herschorn S., et al. Vaginal Reconstructive Surgery for Sphincter Incontinence and Prolapse. Wein: Campbell-Walsh Urology, 9th ed. Ch.66. 2007.

Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardisation of terminology of lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Neurology and Urodynamics 2002; 21:167–78.

Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL. Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 1997; 89:501–6.

Kelly HA. Incontinence of urine in women. Urol Cutan Rev 1913; 17: 291–3.

McCracken GR, Lefebvre G. Mesh-free anterior vaginal wall repair: history or best practice? The Obstetrician & Gynaecologist. 2007; 9:233–242. RCOG.

Graves EJ, Gillum BS. National Hospital Discharge Survey: Annual summary, 1994. National Center for Health Statistics. Vital Health Stat 13(128). 1997.

Vollebregt A, Fischer K, Gietelink D, van der Vaart C. Primary surgical repair of anterior vaginal prolapse: a randomised trial comparing anatomical and functional outcome between anterior colporrhaphy and trocar-guided transobturator anterior mesh. BJOG 2011; 118:1518–1527.

El-Nazer M, Gomma I, Ismail Madkour W. Anterior colporrhaphy versus repair with mesh for anterior vaginal wall prolapse: a comparative clinical study. Arch Gynecol Obstet. 2012 May 31. Artículo en proceso de publicación

Altman D, Väyrynen T, Engh ME, Axelsen S, Falconer C; Nordic Transvaginal Mesh Group. Anterior Colporrhaphy versus Transvagina Mesh for Pelvic-Organ Prolapse. N Engl J Med. 2011 May 12; 364(19):1826-36.

Natale F, Marziali S, Cervigni M. Tension-free cystocele repair (TCR): longterm follow-up. Proceedings of the 25th Annual Meeting of the International Urogynecological Association, 22–25 October 2000, Rome, Italy.

Badlani G, Davila GW, Michael MC, Rosette JJM. Continency Current Concepts. 2009; 24: 329-341.

Petros PE. The Female Pelvic Floor. Function, dysfunction and management according with integral theory. 2nd ed. 2007; 2-4: (14-120).

Maher CM, Feiner B, Baessler K, Glazener CM. Surgical management of pelvic organ prolapse in women: the updated summary version Cochrane review Int Urogynecol J. 2011 Nov; 22(11): 1445-57.

Nguyen JAN, Burchett Jr. Outcome after anterior vaginal prolapse repair: a randomized controlled trial. Obstet Gynecol. 2008; 111:891–898.

World Health Statistics report 2011. World Health Organization.

Nygaard I, Barber M. Prevalence of Symptomatic Pelvic Floor Disorders in US Women. JAMA. 2008 September 17; 300(11): 1311–1316.

Vimplis S, Hooper P. Assessment and management of pelvic organ prolapse. Current Obstetrics & Gynaecology 2005; 15: 387–393.

Abed H, Rogers G. Urinary Incontinence and Pelvic Organ Prolapse: Diagnosis and Treatment. Med Clin N Am. 2008; 92: 1273–1293.

Nygaard I, Bradley C, Brandt D. Pelvic Organ Prolapse in Older Women: Prevalence and Risk Factors. Obstet Gynecol 2004; 104: 489–97.

Weber Am, Abrams P, Brubaker L, Cundiff G, Davis G, Dmochowski R, Fischer J, Hull T, Nygaard I, Weidner AC. The Standardization of Terminology for Researchers in Female Pelvic Floor Disorders. Int Urogynecol J 2001; 12: 178–186.

Young S.Vaginal Surgery for Pelvic Organ Prolapse. Obstet Gynecol Clin N Am 2009; 36: 565–584.

DeLancey JO. Anatomical aspects of vaginal eversion after hysterectomy. Am J Obstet Gynecol 1992; 166: 1717–28.

Shull BL, Benn SJ, Kuehl TJ. Surgical management of prolapse of the anterior vaginal segment: An analysis of support defects, operative morbidity, and anatomic outcome. Am J Obstet Gynecol 1994; 171 (6): 1429 – 1439.

Elkins TE, Chesson RR, Videla F. Transvaginal paravaginal repair: A useful adjunctive procedure in pelvic relaxation surgery. J Pelvic Surg 2000; 6:11 – 15.

Mallipeddi P, Kohli N, Steele AC, Owens RG, Karram MM. Vaginal paravaginal repair in the surgical treatment of anterior vaginal wall prolapse. Prim Care Update Ob Gyn. 1998 Jul 1; 5(4): 199-200.

Corriere J, Sandler C. Diagnóstico y tratamiento de las lesiones vesicales. Urol Clin N Am. 2006; 33: 67-71.

TEME 0085 2012

Palavras-Chave #ENFERMEDADES DEL APARATO URINARIO #CIRUGÍA UROGINECOLÓGICA #CIRUGÍA OBSTETRICA #GINECOLOGÍA #Pelvic organ prolapse #Anterior compartment #Anterior colporrhaphy site specific #Postoperative complications
Tipo

info:eu-repo/semantics/bachelorThesis

info:eu-repo/semantics/acceptedVersion