Intraoperative and Postoperative Gastrointestinal Complications Associated With Laparoscopic Sacrocolpopexy

Warner, William B.; Vora, Sonali; Alonge, Angela; Welgoss, J.; Hurtado, Eric A.; Pechmann, Walter S. von

doi:10.1097/spv.0b013e3182724648

Cited by 14 publications

(7 citation statements)

References 8 publications

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“…We found patient's age and prior laparotomy were significantly associated with the occurrence of significant GI morbidity, which is consistent with the results of previous studies [6,7]. The association of age and postoperative ileus has been also found in other abdominal surgeries [16,17].…”

Section: Discussionsupporting

confidence: 92%

“…And it has been found that patients undergoing laparoscopic colon resection have lower levels of systemic cytokines after surgery compared with those who had open procedures [22]. Although it is unknown that the same benefit of laparoscopic approach can be applied to SCP, a recent paper evaluating GI complications after laparoscopic SCP showed low rates of postoperative ileus or small bowel obstruction [7]. A prospective, randomized trial evaluating whether laparoscopic SCP may reduce the risk of significant GI morbidity compared with laparotomic SCP is warranted.…”

Section: Discussionmentioning

confidence: 99%

“…The sole risk factor for ileus or small bowel obstruction was older age [6]. Another study that also included largest study population reported that significant GI morbidity after laparoscopic SCP were relatively low (about 1%) and associated with prior laparotomy [7]. Most of women included in these two studies are Caucasian, therefore the results cannot be applied to different ethnic backgrounds of women.…”

Section: Introductionmentioning

confidence: 99%

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Significant gastrointestinal morbidity after sacrocolpopexy: The incidence and risk factors

Kim

Jeon

2014

Obstet Gynecol Sci

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ObjectiveThis study aimed to quantify the risk of significant gastrointestinal (GI) morbidity after sacrocolpopexy (SCP), and to identify related risk factors.MethodsA retrospective study was performed of 258 patients who underwent laparotomic SCP for symptomatic pelvic organ prolapse (POP) from November 2008 to August 2013. By the review of medical records, the frequency of significant GI morbidity that resulted in a prolonged initial hospitalization, readmission, or reoperation was assessed. Thereafter, risk factors for significant GI morbidity were assessed using univariate and multivariate analyses.ResultsTen patients (3.9%) were identified as having significant GI morbidity; nine (3.5%) had a prolonged initial hospital stay or were readmitted for the medical treatment of postoperative ileus and 1 (0.4%) underwent reoperation for small bowel obstruction. The occurrence of significant GI morbidity was significantly associated with patient's age and prior laparotomy. By multivariable logistic regression analysis, age (odds ratio [OR], 1.14; 95% confidence interval [CI], 1.01-1.27; P=0.03) and prior laparotomy (OR, 6.82; 95% CI, 1.37-34.07; P=0.02) were found as independent risk factors for significant GI morbidity.ConclusionOne in 25 (3.9%) women after SCP experiences significant GI morbidity. Particularly, women with older age and prior laparotomy have a higher risk for significant GI morbidity. This data will aid preoperative counseling for Korean POP patients undergoing SCP.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Significant gastrointestinal morbidity after sacrocolpopexy: The incidence and risk factors

Kim

Jeon

2014

Obstet Gynecol Sci

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“…This rate is similar to that reported in other studies in which the mesh is covered by peritoneum. 17 Our study provides further evidence that omitting reperitonealization of the mesh is safe.…”

Section: Discussionmentioning

confidence: 75%

A Streamlined Surgical Approach to Laparoscopic Sacrocolpopexy for Post-Hysterectomy Vault Prolapse

Zebede

Dawood

Alarab

et al. 2016

Journal of Obstetrics and Gynaecology Canada

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“…Актуальность. Моторно-эвакуаторная дисфункция желудочно-кишечного тракта широко распространена в послеоперационном периоде и возникает не только после больших операций на брюшной полости, забрюшинном пространстве, но и после небольших по объему оперативных вмешательств, в том числе выполненных лапароскопически [1,2]. Целью…”

Section: влияние L-аргинина на скорость разрешения послеоперационногоunclassified

Effect of L-arginine on the resolution rate of postoperative ileus in patients with urgent abdominal pathology

Novitskaya-Usenko

Kligunenko

Dyomin

et al. 2018

prmd

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Background. Postoperative ileus is widespread in the postoperative period and occurs not only after extended operations on the abdominal cavity, retroperitoneal cavity, but also after minor surgical interventions, including laparoscopic operations [1, 2]. The aim of this study is to increase the effectiveness of intensive care after urgent abdominal surgeries by developing a drug correction for bowel motility disorders based on studying of the motor and evacuator function of the gastrointestinal tract, inflammatory markers, hemodynamic parameters and electrolyte blood composition. Materials and methods. 51 patients were examined, who underwent urgent surgical interventions with laparotomy access for infringed hernias, acute intestinal obstruction, perforation of duodenal ulcers. Depending on the variant of drug correction of postoperative intestinal motility disorder, patients were divided into 2 groups. The first (control) group (n = 27). In the postoperative period, the pharmacological correction of the motor-evacuator function of the gastrointestinal tract was performed by combining a solution of 0,5% metoclopramide and neostigmine bromide. The second (main) group (n = 24). In the postoperative period, the pharmacological correction of the motor-evacuator function of the gastrointestinal tract was performed by combining 0.5% metoclopramide solution and L-arginine (Tivortin, Yuriya-Farm, Ukraine). Motorevacuation disorders of the gastrointestinal tract (the frequency of development of bloating, nausea, vomiting, delay in the escape of gases, an independent moving of gases, measurement of intra-abdominal pressure), parameters of hemodynamics, the level of systolic, diastolic, mean arterial pressure, cardiac index, stroke volume, total peripheral vascular resistance, heart rate, minute volume of blood circulation and left ventricular power, markers of inflammation (leukocyte count, fibrinogen, IL-lα, TNFα, IL-10, calculation of leukocyte intoxication index, the study of electrolytes of blood serum (Na+, K+, Ca2+, Cl- ) were studied before and after 1st, 3rd and 7th days after the operation. Results. The use of L-arginine leads to a decrease in the phenomena of peripheral vasospasm, which, improving the microcirculation of the intestinal wall leads to a faster recovery of the motor-evacuation function of the gastrointestinal tract. With standard prokinetic therapy (combination of metoclopramide with neostigmine bromide), the number of patients with elevated intra-abdominal pressure increases in 92,1%, оn the second day after surgery, the number of patients with elevated intra-abdominal pressure exceeds the norm in 100%. The resumption of intestinal motility 3 days after the operation is accompanied by the normalization of intra-abdominal pressure in 55% of patients. Against the backdrop of the use of L-arginine with metoclopramide on day 1 after the operation, the number of patients with an increase in intra-abdominal pressure does not exceed 50%. 37,5% of them have elevated intra-abdominal pressure, 8,3% have abdominal hypertension of the 1st degree. On the second day of the observation, intraabdominal pressure in 41,7% patients normalized, abdominal hypertension of 1 degree was noted in 16,7%. of them. On the 3rd day after surgery, intra-abdominal pressure corresponded to the norm in 79,2% of patients, abdominal hypertension of 1st degree was registered in 8,3% of patients. Сonclusions. The use of a combination of metoclopramide with L-arginine reduces the stress on the myocardium, activates - anti-inflammatory link of the cytokine system, accelerates the normalization of intra-abdominal pressure, increases the rate of self-evacuation, independent defecation, and reduces the patients’ stay in the intensive care, which makes it possible to recommend it as the most optimal remedy for resuming motor activity intestines after urgent operations in abdominal surgery.

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Intraoperative and Postoperative Gastrointestinal Complications Associated With Laparoscopic Sacrocolpopexy

Abstract: The rates of GI complications in laparoscopic sacrocolpopexy are low. Prior abdominal surgery was associated with an increased risk of functional GI complications, but not bowel injury. This information should assist surgeons with preoperative patient counseling.

Cited by 14 publications

References 8 publications

Significant gastrointestinal morbidity after sacrocolpopexy: The incidence and risk factors

Significant gastrointestinal morbidity after sacrocolpopexy: The incidence and risk factors

A Streamlined Surgical Approach to Laparoscopic Sacrocolpopexy for Post-Hysterectomy Vault Prolapse

Effect of L-arginine on the resolution rate of postoperative ileus in patients with urgent abdominal pathology

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