Safety of laparoscopic ventral rectopexy in the elderly: results from a nationwide database.
Dis Colon Rectum
; 58(3): 339-43, 2015 Mar.
Article
em En
| MEDLINE
| ID: mdl-25664713
ABSTRACT
BACKGROUND:
Laparoscopic ventral rectopexy is an established procedure in the treatment of posterior pelvic organ prolapse. It is still unclear whether this procedure can be performed safely in the elderly.OBJECTIVE:
This study aimed to assess the effects of age on the outcome of laparoscopic ventral rectopexy performed for patients with pelvic organ prolapse.DESIGN:
This study was a retrospective cohort analysis with data from a national registry. SETTINGS The study was conducted in a tertiary care setting. PATIENTS Patients undergoing laparoscopic ventral rectopexy were identified from discharge summaries. Patients were stratified according to age, including patients <70 (group A) and ≥ 70 (group B) years old. MAIN OUTCOMEMEASURES:
Variables analyzed included sex, age, diagnosis, associated pelvic organ prolapse, comorbidities, length of stay, complications (Clavien-Dindo scale), and mortality.RESULTS:
Among 4303 patients (98.2% women) who underwent a laparoscopic ventral rectopexy, 1263 (29.4%) were >70 years old (mean age, 76.2 ± 5.0 years). Main diagnoses were vaginal vault prolapse (53.0% [group A] vs 47.0% [group B]; p value not significant) and rectal prolapse (17.7 vs 26.8%; p value not significant). Comorbidity was significantly increased in group B (mean length of stay, 5.6 ± 3.6 vs 4.7 ± 1.8 days; p < 0.001) and minor complications (8.4% vs 5.0%; p < 0.001) were significantly increased in group B, whereas major complications were not different (group A, 0.7%; group B, 0.9%; p = 0.40) after univariate analysis. Multivariate analysis found no significant differences between groups. The subgroup analysis of patients >80 years old (n = 299) showed no differences. Each group had 1 postoperative mortality.LIMITATIONS:
Limitations of the study include its retrospective design, lack of prestudy power calculation, possible inaccuracy of an administrative database, and selection bias.CONCLUSIONS:
Laparoscopic ventral rectopexy appears to be safe in select elderly patients.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
/
Reto
/
Proctoscopia
/
Prolapso Retal
/
Prolapso de Órgão Pélvico
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article