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International Urogynecology Journal

Published in:

01-03-2019 | Original Article

Safety of laparoscopic sacrocolpopexy with concurrent rectopexy: peri-operative morbidity in a nationwide cohort

Authors: Daniel Weinberg, Fares Qeadan, Rohini McKee, Rebecca G. Rogers, Yuko M. Komesu

Published in: International Urogynecology Journal | Issue 3/2019

Abstract

Introduction and hypothesis

Rectopexy and sacrocolpopexy can be performed concurrently to treat rectal and vaginal prolapse. We hypothesized that concurrent procedures might be associated with more complications than rectopexy and sacrocolpopexy alone.

Methods

Patients undergoing laparoscopic sacrocolpopexy or rectopexy, or concurrent laparoscopic sacrocolpopexy and rectopexy were identified in the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database from 2013 to 2016. Preoperative characteristics, operative time, and 30-day post-operative complications were compared between groups. Complications were those defined by the ACS Risk Calculator. Descriptive tests and regression methods were utilized for group comparisons. Significance was set at p < 0.05.

Results

We identified 7,232 laparoscopic sacrocolpopexy, 1,560 laparoscopic rectopexy, and 123 concurrent laparoscopic sacrocolpopexy and rectopexy cases. Patients undergoing concurrent procedures were more commonly white, non-Hispanic, non-diabetic, and smokers. Operative time was longest for concurrent procedures, followed by sacrocolpopexy and rectopexy (p < 0.0001). Patients undergoing isolated rectopexy were more commonly ≥ American Society of Anesthesiologists class 3 (p < 0.0001). Rates of any complication for colpopexy, rectopexy, and concurrent procedures did not differ (6.18%, 7.63%, 8.94%; p = 0.058). Serious complication rates for colpopexy, rectopexy, and concurrent procedures did not differ (5.52%, 6.35%, 8.13%; p = 0.222). Odds of experiencing any complication were higher comparing rectopexy with colpopexy alone (adjusted odds ratio = 1.252, 95% CI 1.002–1.565). Comparing all groups, rectopexy had the highest mortality, reoperation, and transfusion rates (all p < 0.05). Concurrent procedures had the highest surgical site and urinary tract infection rates (all p < 0.05).

Conclusions

Complications were low for all three procedures. Concurrent repair may be appropriate in well-selected patients.

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Title: Safety of laparoscopic sacrocolpopexy with concurrent rectopexy: peri-operative morbidity in a nationwide cohort
Authors: Daniel Weinberg
Fares Qeadan
Rohini McKee
Rebecca G. Rogers
Yuko M. Komesu
Publication date: 01-03-2019
Publisher: Springer International Publishing
Published in: International Urogynecology Journal / Issue 3/2019
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-018-3699-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Safety of laparoscopic sacrocolpopexy with concurrent rectopexy: peri-operative morbidity in a nationwide cohort

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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