Impact of obesity on operative complications and outcome after sacrocolpopexy: A systematic review and meta-analysis

Wen, Qian; Zhao, Zhiwei; Wen, Jiqiu; Yang, Yanlin; Wu, Jiang; Miao, Yong

doi:10.1016/j.ejogrb.2021.01.032

Cited by 9 publications

(3 citation statements)

References 29 publications

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“…The role of obesity as a predisposing risk factor for POP recurrence after surgical correction has not been well established. A systematic review and meta-analysis [5 ▪ ] demonstrated that the complications and curative effects for obese women are comparable with those of nonobese women, except for a higher conversion rate, higher infection rate, longer operative time, and higher estimated blood loss in obese women. Obesity slightly increases RSC's difficulty, although it does not increase the mesh erosion rate or prolapse recurrence rate.…”

Section: Resultsmentioning

confidence: 99%

Robotic sacrocolpopexy in pelvic organ prolapse: a review of current literature

Pushkar

Kasyan

Попов

2021

Current Opinion in Urology

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Purpose of reviewRecently, robotic sacrocolpopexy has become the gold standard for treating genital prolapse. Despite this, there is still much interest in this procedure, and many questions remain unanswered. This review focuses on the most critical articles on this issue that have been published in the last 2 years.Recent findingsA summary of 23 articles is provided. There were no differences in total postoperative complications, postoperative stress incontinence, mesh erosion, and the success of the two surgical techniques in long-term investigations. Obesity modestly increases robotic approach difficulty and does not raise the mesh erosion rate or prolapse recurrence rate. Ultra-light and preprepared meshes with alternative fixation techniques can be applied with these procedures. Another emerging trend is alternative robotic approaches and the use of single-port surgery.SummaryFor women with pelvic organ prolapse, especially the elderly and obese, robotic sacrocolpopexy is well tolerated and effective. Despite highly restricted and heterogeneous data, recent investigations have included single incision methods and new mesh/fixation materials. Randomized trials with large sample size and excellent quality are necessary before the practical implementation of new techniques.

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Section: Resultsmentioning

confidence: 99%

Robotic sacrocolpopexy in pelvic organ prolapse: a review of current literature

Pushkar

Kasyan

Попов

2021

Current Opinion in Urology

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“…Not all iAEs are related to the surgical procedure [35]. Examples include some pre-existing conditions [35] (eg, body mass index [14,36]), medical history (eg, pelvic radiation potentially leading to a difficult posterior prostate detachment with the possibility of rectal perforation [37]), anatomical variations not recognized preoperatively [38] (eg, atypical vessels variants causing intraoperative bleeding requiring prolonged cauterization or vessel suturing), and malfunctioning surgical instruments [39,40] (eg, malfunction of the electrocautery device or malpositioning of the protective sheath of the robotic scissors, leading to a vessel injury). While equipment malfunctions are typically considered a subcategory of surgical complications, they warrant explicit inclusion in these guidelines as they are commonplace, infrequently reported, and often preventable [40,41].…”

Section: Discussionmentioning

confidence: 99%

The Intraoperative Complications Assessment and Reporting with Universal Standards (ICARUS) Global Surgical Collaboration Project: Development of Criteria for Reporting Adverse Events During Surgical Procedures and Evaluating Their Impact on the Postoperative Course

Cacciamani

Sholklapper

Dell’Oglio

et al. 2022

European Urology Focus

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“…The challenges of operating in the setting of obesity have long been recognized 4 and international guidelines regarding peri‐operative optimization have emerged including the Canadian Society of Gynecologists guideline specific to gynecology 5,6 . These are based on the recognition that surgery in the setting of obesity conveys specific additional risks and challenges including high levels of comorbidity, anesthetic risks, and surgical complications including higher rates of surgical site infections, conversion from laparoscopic to open surgery, longer operative time, and longer hospital stay 6–9 . These guidelines specifically include weight loss recommendations, however, there is no clear guidance on duration, target loss, surgical postponement, and the strength of the recommendations are “weak, very low” based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology framework.…”

Section: Introductionmentioning

confidence: 99%

Systematic review of randomized control trials into effective preoperative weight loss interventions and impact on surgical outcomes for major benign gynecological surgery

Atkinson

Pass²,

Megaw

2022

J of Obstet and Gynaecol

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Aims: Limited information exists on what preoperative weight loss interventions (lifestyle, pharmacological, surgical) are effective in improving outcomes of elective, nononcological, gynecological surgery. Obesity rates are increasing and associated with poorer operative outcomes. We aimed to identify high quality studies into preoperative weight loss interventions and perform a systematic review of the literature to guide recommendations for reducing gynecological surgical complications and guide future research. Primary outcomes were mortality and surgical complications including conversion to open surgery, duration of surgery, and recovery. Methods: The review was pre-registered with PROPSERO. A systematic search was undertaken of the major electronic bibliographic databases. Search results were compiled and abstracts of studies identified before application of the Cochrane highly sensitive search strategy (CHSSS) were reviewed. Full text of studies after application of the CHSSS were evaluated for suitability. For data collection and analysis, a minimum three high-quality randomized control trials were required to synthesize data in relation to the primary outcome. Results: No trials met the inclusion criteria. No randomized control trials in gynecological cohorts were identified. Studies in gynecology-oncology were excluded due to the confounding nature of weight loss as a feature of illness as opposed to health optimization. Conclusion: There is limited evidence regarding preoperative weight loss interventions in gynecology. Further research is needed as the prevalence of obesity among women is increasing and definitive surgical management options in gynecology remain essential. PROSPERO registration ID: 165643.

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Impact of obesity on operative complications and outcome after sacrocolpopexy: A systematic review and meta-analysis

Cited by 9 publications

References 29 publications

Robotic sacrocolpopexy in pelvic organ prolapse: a review of current literature

Robotic sacrocolpopexy in pelvic organ prolapse: a review of current literature

The Intraoperative Complications Assessment and Reporting with Universal Standards (ICARUS) Global Surgical Collaboration Project: Development of Criteria for Reporting Adverse Events During Surgical Procedures and Evaluating Their Impact on the Postoperative Course

Systematic review of randomized control trials into effective preoperative weight loss interventions and impact on surgical outcomes for major benign gynecological surgery

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