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Article Dans Une Revue Journal of Clinical Medicine Année : 2023

Serious Complications and Recurrence following Sacrospinous Ligament Fixation for the Correction of Apical Prolapse

Susie de Gracia
  • Fonction : Auteur
Brigitte Fatton
  • Fonction : Auteur
Michel Cosson
  • Fonction : Auteur
Sandrine Campagne-Loiseau
  • Fonction : Auteur
Philippe Ferry
  • Fonction : Auteur
Jean-Philippe Lucot
Philippe Debodinance
  • Fonction : Auteur
Laure Panel
  • Fonction : Auteur
Xavier Deffieux
  • Fonction : Auteur
Olivier Garbin
  • Fonction : Auteur
Caroline Carlier-Guérin
  • Fonction : Auteur
Rajeev Ramanah
  • Fonction : Auteur
Arnaud Fauconnier
  • Fonction : Auteur
Chris Serrand
Renaud de Tayrac

Résumé

Objective: To evaluate the rates of serious complications and reoperation for recurrence following sacrospinous ligament fixation (SSLF) for apical pelvic organ prolapse. Methods: This was a national registry ancillary cohort comparative study. The VIGI-MESH registry includes data from 24 French health centers prospectively collected between May 2017 and September 2021. Time to occurrence of a serious complication or reoperation for genital prolapse recurrence was explored using the Kaplan-Meier curve and Log-rank test. The inverse probability of treatment weighting, based on propensity scores, was used to adjust for between-group differences. Results: A total of 1359 women were included and four surgical groups were analyzed: Anterior SSLF with mesh (n = 566), Anterior SSLF with native tissue (n = 331), Posterior SSLF with mesh (n = 57), and Posterior SSLF with native tissue (n = 405). Clavien-Dindo Grade III complications or higher were reported in 34 (2.5%) cases, with no statistically significant differences between the groups. Pelvic organ prolapse recurrence requiring re-operation was reported in 44 (3.2%) women, this was higher following posterior compared with anterior SSLF (p = 0.0034). Conclusions: According to this large database ancillary study, sacrospinous ligament fixation is an effective and safe surgical treatment for apical prolapse. The different surgical approaches (anterior/posterior and with/without mesh) have comparable safety profiles. However, the anterior approach and the use of mesh were associated with a lower risk of reoperation for recurrence compared with the posterior approach and the use of native tissue, respectively.
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Dates et versions

hal-04220932 , version 1 (28-09-2023)

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Susie de Gracia, Brigitte Fatton, Michel Cosson, Sandrine Campagne-Loiseau, Philippe Ferry, et al.. Serious Complications and Recurrence following Sacrospinous Ligament Fixation for the Correction of Apical Prolapse. Journal of Clinical Medicine, 2023, 12 (2), pp.468. ⟨10.3390/jcm12020468⟩. ⟨hal-04220932⟩
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