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An updated systematic review and network meta-analysis comparing open, laparoscopic and robotic-assisted sacrocolpopexy for managing pelvic organ prolapse

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Abstract

Abdominal sacrocolpopexy is considered as the gold standard treatment for pelvic organ prolapse. Sacrocolpopexy can be performed using open (OSC), laparoscopic (LSC), and robotic-assisted (RSC) approaches. The aim of this study is to compare the outcomes between these three approaches for managing pelvic organ prolapse by conducting a systematic review and network meta-analysis. A systematic search was performed in different databases from their earliest records to April 2021 with no restriction on languages. Only randomized controlled trials that compared the outcomes between OSC, LSC, and RSC were included in this study. A total of 6 studies with 486 participants were included in this study. Operative time was significantly shorter in OSC than in RSC and LSC. The probability rank showed less estimated blood loss in RSC and lowest overall postoperative complications in LSC. Probability scores also showed best anatomical outcomes for postoperative points C and Bp in RSC and for point Ba in LSC. Despite significantly longer operative time, RSC and LSC may provide better anatomical outcomes, less estimated blood loss, and less overall postoperative complications than OSC. However, this study did not find significant differences between RSC and LSC in efficacy and safety.

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All data generated or analyzed during this study are included in this published paper.

References

  1. Barber MD, Maher C (2013) Epidemiology and outcome assessment of pelvic organ prolapse. Int Urogynecol J 24(11):1783–1790

    Article  Google Scholar 

  2. Fleischer K, Thiagamoorthy G (2020) Pelvic organ prolapse management. Post Reprod Health 26(2):79–85

    Article  CAS  Google Scholar 

  3. Ng-Stollmann N et al (2020) The international discussion and the new regulations concerning transvaginal mesh implants in pelvic organ prolapse surgery. Int Urogynecol J 31(10):1997–2002

    Article  Google Scholar 

  4. Nygaard IE et al (2004) Abdominal sacrocolpopexy: a comprehensive review. Obstet Gynecol 104(4):805–823

    Article  Google Scholar 

  5. Nosti PA et al (2014) Outcomes of abdominal and minimally invasive sacrocolpopexy: a retrospective cohort study. Female Pelvic Med Reconstr Surg 20(1):33–37

    Article  Google Scholar 

  6. Truong M et al (2016) Advantages of robotics in benign gynecologic surgery. Curr Opin Obstet Gynecol 28(4):304–310

    Article  Google Scholar 

  7. Moher D et al (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6(7):e1000097

    Article  Google Scholar 

  8. Bump RC et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175(1):10–17

    Article  CAS  Google Scholar 

  9. Rücker G et al. (2015) Package ‘netmeta’. Network meta-analysis using frequentist methods (version 0.7–0)

  10. Salanti G et al (2014) Evaluating the quality of evidence from a network meta-analysis. PLoS ONE 9(7):e99682

    Article  CAS  Google Scholar 

  11. Jackson D et al (2018) A matrix-based method of moments for fitting multivariate network meta-analysis models with multiple outcomes and random inconsistency effects. Biometrics 74(2):548–556

    Article  Google Scholar 

  12. Rücker G, Schwarzer G (2015) Ranking treatments in frequentist network meta-analysis works without resampling methods. BMC Med Res Methodol 15(1):1–9

    Article  Google Scholar 

  13. Paraiso MF et al (2011) Laparoscopic compared with robotic sacrocolpopexy for vaginal prolapse: a randomized controlled trial. Obstet Gynecol 118(5):1005–1013

    Article  Google Scholar 

  14. Anger JT et al (2014) Robotic compared with laparoscopic sacrocolpopexy: a randomized controlled trial. Obstet Gynecol 123(1):5–12

    Article  Google Scholar 

  15. Illiano E et al (2019) Robot-assisted vs laparoscopic sacrocolpopexy for high-stage pelvic organ prolapse: a prospective, randomized, single-center study. Urology 134:116–123

    Article  Google Scholar 

  16. Freeman RM et al (2013) A randomised controlled trial of abdominal versus laparoscopic sacrocolpopexy for the treatment of post-hysterectomy vaginal vault prolapse: LAS study. Int Urogynecol J Pelvic Floor Dysfunct 24(3):377–384

    Article  CAS  Google Scholar 

  17. Costantini E et al (2016) Laparoscopic versus abdominal sacrocolpopexy: a randomized, controlled trial. J Urol 196(1):159–165

    Article  Google Scholar 

  18. Coolen ALWM et al (2017) Laparoscopic sacrocolpopexy compared with open abdominal sacrocolpopexy for vault prolapse repair: a randomised controlled trial. Int Urogynecol J 28(10):1469–1479

    Article  Google Scholar 

  19. De Gouveia De Sa M et al (2016) Laparoscopic versus open sacrocolpopexy for treatment of prolapse of the apical segment of the vagina: a systematic review and meta-analysis. Int Urogynecol J 27(1):3–17

    Article  Google Scholar 

  20. Chang CL, Chen CH, Chang SJ (2021) Comparing the outcomes and effectiveness of robotic-assisted sacrocolpopexy and laparoscopic sacrocolpopexy in the treatment of pelvic organ prolapse. Int Urogynecol J. https://doi.org/10.1007/s00192-021-04741-x

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors would like to thank the team of Taipei Tzu Chi Hospital Library and the research team of Taipei Tzu Chi Hospital for their support in the database search and the development of this paper.

Funding

The authors did not receive support from any organization for this study.

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Authors and Affiliations

  1. Division of Urology, Taipei Tzu Chi Hospital, Tzu Chi Medical Foundation, New Taipei City, 231, Taiwan

    Chia-Lun Chang, Stephen Shei-Dei Yang & Shang-Jen Chang

  2. School of Medicine, Tzu Chi University, Hualien City, 970, Taiwan

    Chia-Lun Chang, Stephen Shei-Dei Yang & Shang-Jen Chang

  3. Department of Neurology, Taipei Municipal Wanfang Hospital, Taipei, Taiwan

    Chun-Hua Chen

Authors
  1. Chia-Lun Chang
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  2. Chun-Hua Chen
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  3. Stephen Shei-Dei Yang
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  4. Shang-Jen Chang
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Contributions

C-LC: study design, data collection, data analysis, and original manuscript writing. C-HC: recheck data collection and analysis, and manuscript reviewing. SS-DY: supervise data collection and analysis, and manuscript reviewing. S-JC: supervise data collection and analysis, and manuscript reviewing. All authors reviewed and approved the final manuscript as submitted and agreed to be accountable for all aspects of the work.

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Correspondence to Shang-Jen Chang.

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The authors have no relevant financial or non-financial interests to disclose.

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This is a systematic review and network meta-analysis study. The Research Ethics Committee has confirmed that no ethical approval is required.

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Chang, CL., Chen, CH., Yang, S.SD. et al. An updated systematic review and network meta-analysis comparing open, laparoscopic and robotic-assisted sacrocolpopexy for managing pelvic organ prolapse. J Robotic Surg 16, 1037–1045 (2022). https://doi.org/10.1007/s11701-021-01329-x

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  • DOI: https://doi.org/10.1007/s11701-021-01329-x

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