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Outcomes of abdominal and minimally invasive sacrocolpopexy: a retrospective cohort study
Patrick A Nosti1, Uduak Umoh Andy, Sarah Kane
1From the *FPMRS Division, Obstetrics and Gynecology Department, Medstar Washington Hospital Center, Georgetown University School of Medicine, Washington, DC; †FPMRS Division, Obstetrics and Gynecology Department, University of Pennsylvania, Philadelphia, PA; ‡Division of Urogynecology, Obstetrics and Gynecology Department, Case Western Reserve University, MetroHealth Medical Center; §FPMRS Division, Obstetrics and Gynecology Department, University of Oklahoma, Oklahoma City, OK; and ∥FPMRS Division, Obstetrics and Gynecology Department, Rambam Health Care Campus, Haifa, Israel.
Objective:
To compare perioperative and postoperative surgical outcomes between and among open and minimally invasive sacrocolpopexies (MISCs).
Methods:
We performed a multicenter retrospective cohort study comparing abdominal sacrocolpopexy (ASC) and MISC from January 1999 to December 2010.
Results:
A total of 1124 subjects underwent sacrocolpopexy, with 589 ASCs and 535 MISCs. Within the MISC group, 273 were laparoscopic (LSC) and 262 were robotic (RSC). Abdominal sacrocolpopexy was associated with greater overall complication rate compared with MISC (20.0% vs 12.7%; P = 0.001). After controlling for difference in length of follow-up, there was no significant difference in the rate of anatomical failure between the ASC and MISC groups. The MISC group had shorter hospitalization, less blood loss, but longer operative times compared with the ASC group. When comparing LSC to RSC, there was no difference in anatomic failures (7.7% vs 6.9%; P = 0.74). However, LSC was associated with more complications compared with RSC (18% vs 7%; P < 0.02). In addition, LSC had higher blood loss, less operative time, and shorter hospital stay compared with RSC.
Conclusion:
Although anatomic results are similar, ASC is associated with a higher rate of complications compared with MISC.
