Robot-assisted surgery for the management of apical prolapse: a bicentre prospective cohort study

dc.check.date2010-03-29
dc.check.infoAccess to this article is restricted until 12 months after publication by request of the publisher.en
dc.contributor.authorvan Zanten, F.
dc.contributor.authorSchraffordt Koops, S. E.
dc.contributor.authorO'Sullivan, Orfhlaith E.
dc.contributor.authorLenters, E.
dc.contributor.authorBroeders, I. A. M. J.
dc.contributor.authorO'Reilly, Barry A.
dc.date.accessioned2019-04-08T14:35:26Z
dc.date.available2019-04-08T14:35:26Z
dc.date.issued2019-03-29
dc.date.updated2019-04-08T14:20:05Z
dc.description.abstractObjective: Robot‐assisted surgery is a recognized treatment for pelvic‐organ prolapse. Many of the surgical subgroup outcomes for apical prolapse are reported together leading to a paucity of homogenous data. Design: Prospective observational cohort study (https://clinicaltrials.gov; identifier NCT01598467) assessing outcomes for homogeneous subgroups of robot‐assisted apical prolapse surgery. Setting: Two European tertiary referral hospitals. Population: Consecutive patients undergoing robot‐assisted sacrocolpopexy (RASC) and supracervical hysterectomy with sacrocervicopexy (RSHS). Methods: Anatomical cure (simplified Pelvic Organ Prolapse Quantification (sPOPQ) stage 1,), subjective cure (symptoms of bulge) and quality of life (Pelvic Floor Impact Questionnaire [PFIQ‐7]). Main Outcome measures: Primary outcome: anatomical and subjective cure. Secondary outcomes: surgical safety and intraoperative variables. Results: Total 305 patients included (RASC N=188, RSHS N=117). Twelve months follow‐up available for 144 (RASC 76.6%) and 109 (RSHS 93.2%). Anatomical success of the apical compartment occurred in 91% (RASC) and in 99% (RSHS). In all compartments, success percentages were 67% and 65% respectively. Most recurrences were anterior compartment (15.7% RASC [symptomatic 12.1%]; 22.9% RSHS [symptomatic 4.8%]). Symptoms of bulge improved from 97.4% to 17.4% (p<0.0005). PFIQ‐7 scores improved from 76.7 ± 62.3 to 13.5 ± 31.1 (p<0.0005). Duration of surgery increased significantly in RSHS (183.1 ± 38.2 versus 145.3 ± 29.8 [p<0.0005]). Intraoperative complications and conversion rates were low (RASC: 5.3% and 4.3%; RSHS: 0.0% and 0.0%). Four severe postoperative complications occurred after RASC (2.1%) and one after RSHS (1.6%). Conclusion: This is the largest reported prospective cohort study on robot‐assisted apical prolapse surgery. Both procedures are safe, with durable results.en
dc.description.statusPeer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationvan Zanten, F., Schraffordt Koops, S. E., O'Sullivan, O. E., Lenters, E., Broeders, I. A. M. J. and O'Reilly, B. A. (2019) 'Robot-assisted Surgery for the management of Apical Prolapse: A Bicentre Prospective Cohort Study', BJOG: An International Journal of Obstetrics & Gynaecology, In Press, doi: 10.1111/1471-0528.15696en
dc.identifier.doi10.1111/1471-0528.15696en
dc.identifier.eissn1471-0528
dc.identifier.issn1470-0328
dc.identifier.journaltitleBJOG : an international journal of obstetrics and gynaecologyen
dc.identifier.urihttps://hdl.handle.net/10468/7726
dc.language.isoenen
dc.publisherWileyen
dc.relation.urihttps://obgyn.onlinelibrary.wiley.com/doi/abs/10.1111/1471-0528.15696
dc.rights© 2019 Royal College of Obstetricians and Gynaecologists. This is the peer reviewed version of the following article: van Zanten, F et al. (2019), Robot‐assisted Surgery for the management of Apical Prolapse: A Bicentre Prospective Cohort Study. BJOG: Int J Obstet Gy. Accepted Author Manuscript.which has been published in final form at https://doi.org/10.1111/1471-0528.15696. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.en
dc.subjectPelvic organ prolapseen
dc.subjectSacral colpopexyen
dc.subjectSacrocervicopexyen
dc.subjectSacrocolpopexyen
dc.subjectRobot-assisteden
dc.titleRobot-assisted surgery for the management of apical prolapse: a bicentre prospective cohort studyen
dc.typeArticle (peer-reviewed)en
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