Long-term Data on Graft-Related Complications After Sacrocolpopexy With Lightweight Compared With Heavier-Weight Mesh
To estimate the long-term incidence and characteristics of graft-related complications, rate of reintervention for graft-related complications and prolapse, and subjective and anatomical outcomes after laparoscopic sacrocolpopexy with heavier-weight (more than 44 g/m2) compared with lightweight (28...
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| Veröffentlicht in: | Obstetrics and gynecology (New York. 1953) 2023-01, Vol.141 (1), p.189-198 |
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| creator | Page, Ann-Sophie Cattani, Laura Pacquée, Stefaan Claerhout, Filip Callewaert, Geertje Housmans, Susanne Van der Aa, Frank D'Hoore, André Deprest, Jan |
| description | To estimate the long-term incidence and characteristics of graft-related complications, rate of reintervention for graft-related complications and prolapse, and subjective and anatomical outcomes after laparoscopic sacrocolpopexy with heavier-weight (more than 44 g/m2) compared with lightweight (28 g/m2) polypropylene mesh, the latter with resorbable poliglecaprone component.
We conducted a single-center study that compared two consecutive prospective cohorts of patients who were undergoing laparoscopic sacrocolpopexy for symptomatic stage 2 or greater cervical or vault prolapse, by using either heavier-weight polypropylene mesh or lightweight polypropylene mesh at a similar duration of follow-up. The primary outcome was the occurrence of graft-related complications and their nature. Secondary outcomes included reinterventions for graft-related complications, recurrent apical prolapse, a subjective outcome (PGIC [Patient Global Impression of Change] score 4 or higher), and an anatomical outcome (point C -1 cm or greater).
We identified consecutive patients: 101 were implanted with heavier-weight polypropylene, and 238 were implanted with lightweight polypropylene; all were audited at comparable follow-up times (heavier-weight mesh: 97 months [interquartile range 16 months]; lightweight mesh: 92.5 months [interquartile range 58 months]). Graft-related complications were more frequent in patients with heavier-weight than lightweight mesh (22.8% [23/101] vs 7.3% [13/178]; hazard ratio [HR] 3.3, 95% CI 1.6-7.1), more frequently symptomatic (heavier-weight mesh: 16.8% [17/101] vs lightweight mesh: 2.8% [5/178]; HR 6.0, 95% CI 2.5-14.3), and more frequently lead to reintervention for graft-related complications (heavier-weight mesh: 18.8% [19/101] vs lightweight mesh: 2.1% [5/238]; HR 4.6, 95% CI 1.9-11.2). The vast majority of patients improved (PGIC score 4 or higher), without difference between groups (heavier-weight mesh: 71/84 [84.9%]; lightweight mesh: 154/178 [86.5%]; HR 0.8, 95% CI 0.6-1.1); neither was there a difference in anatomical failure rate (heavier-weight mesh: 1/60 [1.7%] vs lightweight mesh: 8/131 [6.1%]; HR 0.3, 95% CI 0.1-1.4). Reoperations for recurrent vault prolapse were scarce (0.0% in heavier-weight mesh, vs 0.4% in lightweight mesh).
In two consecutive cohorts, the number of graft-related complications, symptomatic graft-related complications, and reinterventions for graft-related complications were higher in patients implanted with he |
| doi_str_mv | 10.1097/AOG.0000000000005021 |
| format | Article |
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We conducted a single-center study that compared two consecutive prospective cohorts of patients who were undergoing laparoscopic sacrocolpopexy for symptomatic stage 2 or greater cervical or vault prolapse, by using either heavier-weight polypropylene mesh or lightweight polypropylene mesh at a similar duration of follow-up. The primary outcome was the occurrence of graft-related complications and their nature. Secondary outcomes included reinterventions for graft-related complications, recurrent apical prolapse, a subjective outcome (PGIC [Patient Global Impression of Change] score 4 or higher), and an anatomical outcome (point C -1 cm or greater).
We identified consecutive patients: 101 were implanted with heavier-weight polypropylene, and 238 were implanted with lightweight polypropylene; all were audited at comparable follow-up times (heavier-weight mesh: 97 months [interquartile range 16 months]; lightweight mesh: 92.5 months [interquartile range 58 months]). Graft-related complications were more frequent in patients with heavier-weight than lightweight mesh (22.8% [23/101] vs 7.3% [13/178]; hazard ratio [HR] 3.3, 95% CI 1.6-7.1), more frequently symptomatic (heavier-weight mesh: 16.8% [17/101] vs lightweight mesh: 2.8% [5/178]; HR 6.0, 95% CI 2.5-14.3), and more frequently lead to reintervention for graft-related complications (heavier-weight mesh: 18.8% [19/101] vs lightweight mesh: 2.1% [5/238]; HR 4.6, 95% CI 1.9-11.2). The vast majority of patients improved (PGIC score 4 or higher), without difference between groups (heavier-weight mesh: 71/84 [84.9%]; lightweight mesh: 154/178 [86.5%]; HR 0.8, 95% CI 0.6-1.1); neither was there a difference in anatomical failure rate (heavier-weight mesh: 1/60 [1.7%] vs lightweight mesh: 8/131 [6.1%]; HR 0.3, 95% CI 0.1-1.4). Reoperations for recurrent vault prolapse were scarce (0.0% in heavier-weight mesh, vs 0.4% in lightweight mesh).
In two consecutive cohorts, the number of graft-related complications, symptomatic graft-related complications, and reinterventions for graft-related complications were higher in patients implanted with heavier-weight polypropylene than when lightweight polypropylene was used. There were no differences in subjective, objective outcomes, and reoperation rates for prolapse.
ClinicalTrials.gov, NCT04378400.
To assist in this audit, the University Hospitals Leuven received support from Ethicon Endosurgery.</description><identifier>ISSN: 0029-7844</identifier><identifier>EISSN: 1873-233X</identifier><identifier>DOI: 10.1097/AOG.0000000000005021</identifier><identifier>PMID: 36701619</identifier><language>eng</language><publisher>United States</publisher><subject>Female ; Gynecologic Surgical Procedures - adverse effects ; Gynecologic Surgical Procedures - methods ; Humans ; Laparoscopy ; Polypropylenes ; Prospective Studies ; Surgical Mesh - adverse effects ; Treatment Outcome</subject><ispartof>Obstetrics and gynecology (New York. 1953), 2023-01, Vol.141 (1), p.189-198</ispartof><rights>Copyright © 2022 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c307t-f3e0008d967ef5c4d3258dc160432446df0f591aeeb65ff02a9b83da47e945773</citedby><cites>FETCH-LOGICAL-c307t-f3e0008d967ef5c4d3258dc160432446df0f591aeeb65ff02a9b83da47e945773</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36701619$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Page, Ann-Sophie</creatorcontrib><creatorcontrib>Cattani, Laura</creatorcontrib><creatorcontrib>Pacquée, Stefaan</creatorcontrib><creatorcontrib>Claerhout, Filip</creatorcontrib><creatorcontrib>Callewaert, Geertje</creatorcontrib><creatorcontrib>Housmans, Susanne</creatorcontrib><creatorcontrib>Van der Aa, Frank</creatorcontrib><creatorcontrib>D'Hoore, André</creatorcontrib><creatorcontrib>Deprest, Jan</creatorcontrib><title>Long-term Data on Graft-Related Complications After Sacrocolpopexy With Lightweight Compared With Heavier-Weight Mesh</title><title>Obstetrics and gynecology (New York. 1953)</title><addtitle>Obstet Gynecol</addtitle><description>To estimate the long-term incidence and characteristics of graft-related complications, rate of reintervention for graft-related complications and prolapse, and subjective and anatomical outcomes after laparoscopic sacrocolpopexy with heavier-weight (more than 44 g/m2) compared with lightweight (28 g/m2) polypropylene mesh, the latter with resorbable poliglecaprone component.
We conducted a single-center study that compared two consecutive prospective cohorts of patients who were undergoing laparoscopic sacrocolpopexy for symptomatic stage 2 or greater cervical or vault prolapse, by using either heavier-weight polypropylene mesh or lightweight polypropylene mesh at a similar duration of follow-up. The primary outcome was the occurrence of graft-related complications and their nature. Secondary outcomes included reinterventions for graft-related complications, recurrent apical prolapse, a subjective outcome (PGIC [Patient Global Impression of Change] score 4 or higher), and an anatomical outcome (point C -1 cm or greater).
We identified consecutive patients: 101 were implanted with heavier-weight polypropylene, and 238 were implanted with lightweight polypropylene; all were audited at comparable follow-up times (heavier-weight mesh: 97 months [interquartile range 16 months]; lightweight mesh: 92.5 months [interquartile range 58 months]). Graft-related complications were more frequent in patients with heavier-weight than lightweight mesh (22.8% [23/101] vs 7.3% [13/178]; hazard ratio [HR] 3.3, 95% CI 1.6-7.1), more frequently symptomatic (heavier-weight mesh: 16.8% [17/101] vs lightweight mesh: 2.8% [5/178]; HR 6.0, 95% CI 2.5-14.3), and more frequently lead to reintervention for graft-related complications (heavier-weight mesh: 18.8% [19/101] vs lightweight mesh: 2.1% [5/238]; HR 4.6, 95% CI 1.9-11.2). The vast majority of patients improved (PGIC score 4 or higher), without difference between groups (heavier-weight mesh: 71/84 [84.9%]; lightweight mesh: 154/178 [86.5%]; HR 0.8, 95% CI 0.6-1.1); neither was there a difference in anatomical failure rate (heavier-weight mesh: 1/60 [1.7%] vs lightweight mesh: 8/131 [6.1%]; HR 0.3, 95% CI 0.1-1.4). Reoperations for recurrent vault prolapse were scarce (0.0% in heavier-weight mesh, vs 0.4% in lightweight mesh).
In two consecutive cohorts, the number of graft-related complications, symptomatic graft-related complications, and reinterventions for graft-related complications were higher in patients implanted with heavier-weight polypropylene than when lightweight polypropylene was used. There were no differences in subjective, objective outcomes, and reoperation rates for prolapse.
ClinicalTrials.gov, NCT04378400.
To assist in this audit, the University Hospitals Leuven received support from Ethicon Endosurgery.</description><subject>Female</subject><subject>Gynecologic Surgical Procedures - adverse effects</subject><subject>Gynecologic Surgical Procedures - methods</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Polypropylenes</subject><subject>Prospective Studies</subject><subject>Surgical Mesh - adverse effects</subject><subject>Treatment Outcome</subject><issn>0029-7844</issn><issn>1873-233X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkMtOwzAQRS0EoqXwBwhlycbFjp04WVYFWqQgJB4qu8hNxm1QUgfbAfr3uA8QwovxSHPvPA5C55QMKUnF1ehhMiR_XkRCeoD6NBEMh4y9HqI-IWGKRcJ5D51Y--ZFNE7ZMeqxWPiUpn3UZXq1wA5ME1xLJwO9CiZGKocfoZYOymCsm7auCukqvbLBSHlp8CQLowtdt7qFr3Uwq9wyyKrF0n3CJm490njztjIF-VGBwbNd8R7s8hQdKVlbONv_A_Rye_M8nuLsYXI3HmW4YEQ4rBj4nZMyjQWoqOAlC6OkLGhMOAs5j0tFVJRSCTCPI6VIKNN5wkrJBaQ8EoIN0OWub2v0ewfW5U1lC6hruQLd2TwUngON4yjxUr6T-tOsNaDy1lSNNOucknwDPPfA8__Ave1iP6GbN1D-mn4Is2-9oHwY</recordid><startdate>20230101</startdate><enddate>20230101</enddate><creator>Page, Ann-Sophie</creator><creator>Cattani, Laura</creator><creator>Pacquée, Stefaan</creator><creator>Claerhout, Filip</creator><creator>Callewaert, Geertje</creator><creator>Housmans, Susanne</creator><creator>Van der Aa, Frank</creator><creator>D'Hoore, André</creator><creator>Deprest, Jan</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20230101</creationdate><title>Long-term Data on Graft-Related Complications After Sacrocolpopexy With Lightweight Compared With Heavier-Weight Mesh</title><author>Page, Ann-Sophie ; Cattani, Laura ; Pacquée, Stefaan ; Claerhout, Filip ; Callewaert, Geertje ; Housmans, Susanne ; Van der Aa, Frank ; D'Hoore, André ; Deprest, Jan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c307t-f3e0008d967ef5c4d3258dc160432446df0f591aeeb65ff02a9b83da47e945773</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Female</topic><topic>Gynecologic Surgical Procedures - adverse effects</topic><topic>Gynecologic Surgical Procedures - methods</topic><topic>Humans</topic><topic>Laparoscopy</topic><topic>Polypropylenes</topic><topic>Prospective Studies</topic><topic>Surgical Mesh - adverse effects</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Page, Ann-Sophie</creatorcontrib><creatorcontrib>Cattani, Laura</creatorcontrib><creatorcontrib>Pacquée, Stefaan</creatorcontrib><creatorcontrib>Claerhout, Filip</creatorcontrib><creatorcontrib>Callewaert, Geertje</creatorcontrib><creatorcontrib>Housmans, Susanne</creatorcontrib><creatorcontrib>Van der Aa, Frank</creatorcontrib><creatorcontrib>D'Hoore, André</creatorcontrib><creatorcontrib>Deprest, Jan</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Obstetrics and gynecology (New York. 1953)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Page, Ann-Sophie</au><au>Cattani, Laura</au><au>Pacquée, Stefaan</au><au>Claerhout, Filip</au><au>Callewaert, Geertje</au><au>Housmans, Susanne</au><au>Van der Aa, Frank</au><au>D'Hoore, André</au><au>Deprest, Jan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term Data on Graft-Related Complications After Sacrocolpopexy With Lightweight Compared With Heavier-Weight Mesh</atitle><jtitle>Obstetrics and gynecology (New York. 1953)</jtitle><addtitle>Obstet Gynecol</addtitle><date>2023-01-01</date><risdate>2023</risdate><volume>141</volume><issue>1</issue><spage>189</spage><epage>198</epage><pages>189-198</pages><issn>0029-7844</issn><eissn>1873-233X</eissn><abstract>To estimate the long-term incidence and characteristics of graft-related complications, rate of reintervention for graft-related complications and prolapse, and subjective and anatomical outcomes after laparoscopic sacrocolpopexy with heavier-weight (more than 44 g/m2) compared with lightweight (28 g/m2) polypropylene mesh, the latter with resorbable poliglecaprone component.
We conducted a single-center study that compared two consecutive prospective cohorts of patients who were undergoing laparoscopic sacrocolpopexy for symptomatic stage 2 or greater cervical or vault prolapse, by using either heavier-weight polypropylene mesh or lightweight polypropylene mesh at a similar duration of follow-up. The primary outcome was the occurrence of graft-related complications and their nature. Secondary outcomes included reinterventions for graft-related complications, recurrent apical prolapse, a subjective outcome (PGIC [Patient Global Impression of Change] score 4 or higher), and an anatomical outcome (point C -1 cm or greater).
We identified consecutive patients: 101 were implanted with heavier-weight polypropylene, and 238 were implanted with lightweight polypropylene; all were audited at comparable follow-up times (heavier-weight mesh: 97 months [interquartile range 16 months]; lightweight mesh: 92.5 months [interquartile range 58 months]). Graft-related complications were more frequent in patients with heavier-weight than lightweight mesh (22.8% [23/101] vs 7.3% [13/178]; hazard ratio [HR] 3.3, 95% CI 1.6-7.1), more frequently symptomatic (heavier-weight mesh: 16.8% [17/101] vs lightweight mesh: 2.8% [5/178]; HR 6.0, 95% CI 2.5-14.3), and more frequently lead to reintervention for graft-related complications (heavier-weight mesh: 18.8% [19/101] vs lightweight mesh: 2.1% [5/238]; HR 4.6, 95% CI 1.9-11.2). The vast majority of patients improved (PGIC score 4 or higher), without difference between groups (heavier-weight mesh: 71/84 [84.9%]; lightweight mesh: 154/178 [86.5%]; HR 0.8, 95% CI 0.6-1.1); neither was there a difference in anatomical failure rate (heavier-weight mesh: 1/60 [1.7%] vs lightweight mesh: 8/131 [6.1%]; HR 0.3, 95% CI 0.1-1.4). Reoperations for recurrent vault prolapse were scarce (0.0% in heavier-weight mesh, vs 0.4% in lightweight mesh).
In two consecutive cohorts, the number of graft-related complications, symptomatic graft-related complications, and reinterventions for graft-related complications were higher in patients implanted with heavier-weight polypropylene than when lightweight polypropylene was used. There were no differences in subjective, objective outcomes, and reoperation rates for prolapse.
ClinicalTrials.gov, NCT04378400.
To assist in this audit, the University Hospitals Leuven received support from Ethicon Endosurgery.</abstract><cop>United States</cop><pmid>36701619</pmid><doi>10.1097/AOG.0000000000005021</doi><tpages>10</tpages></addata></record> |
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| source | MEDLINE; Journals@Ovid Complete |
| subjects | Female Gynecologic Surgical Procedures - adverse effects Gynecologic Surgical Procedures - methods Humans Laparoscopy Polypropylenes Prospective Studies Surgical Mesh - adverse effects Treatment Outcome |
| title | Long-term Data on Graft-Related Complications After Sacrocolpopexy With Lightweight Compared With Heavier-Weight Mesh |
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