ABSTRACT
OBJECTIVES: The purpose of this systematic review is to present and compare results from studies that have been using autologous tissue for POP repair. METHODS: Systematic review was done according to the Cochrane Handbook for Systematic Reviews. We aimed to retrieve reports of published and ongoing studies on the efficacy and safety of autologous tissue in vaginal vault prolapse repair. The databases searched were MEDLINE (PubMed interface), Scopus, Cohrane Central Register of Controlled Trials (CENTRAL) and ClinicalTrials.gov. RESULTS: The success rate varied among studies. In fascia-lata group success rate reports varied from 83 to a 100%, with a median follow-up from 12 to 52 months among studies. Rectus fascia reported success rates from 87 to a 100% with a follow-up of 12 months to longest of 98 months. CONCLUSION: Autologous tissues show satisfying outcomes in terms of safety and efficacy. Sacrocolpopexy procedure with fascia lata has better outcome in term of treatment of prolapse. Harvesting place on lateral side of buttock has more complications in comparison with rectus fascia but size of the graft can be wider in fascia-lata group.
Subject(s)
Fascia Lata , Pelvic Organ Prolapse , Humans , Female , Pelvic Organ Prolapse/surgery , Fascia Lata/transplantation , Gynecologic Surgical Procedures/methods , Treatment Outcome , Transplantation, Autologous , Fascia/transplantation , Rectus Abdominis/transplantation , Rectus Abdominis/surgeryABSTRACT
INTRODUCTION: Hysterectomy is one of the most common major gynecological surgeries, and it is performed for benign and malignant reasons. Currently, five types of hysterectomies are described: vaginal (VH), abdominal (AH), laparoscopic (LH), robotic, and vNOTES (vaginal natural orifice transluminal endoscopic surgery). This paper compares these two types of surgery in obese patients by analyzing the surgeries performed by our team. MATERIALS AND METHODS: The research was conducted from January 2022 to December 2023 at the Department of Gynecology and Obstetrics of the General Hospital in Zadar. The study included female patients aged 18-75 years with a BMI > 30 kg/m2, regardless of parity, who were operated on for benign pathology. RESULTS: There were 24 patients included in total. One conversion was observed in the TLH group because of excessive bleeding. Median operative time (IQR) was significantly lower in the vNOTES group (p < 0.05) than in the TLH group 35 (10.9) vs 125 (74.0) min. CONCLUSION: The results concerning the duration of surgery, conversion rate, and postoperative bleeding and complications show that vNOTES hysterectomies seem to be feasible for obese patients. Further studies are needed to confirm these observations.
Subject(s)
Hysterectomy , Laparoscopy , Natural Orifice Endoscopic Surgery , Obesity , Operative Time , Humans , Female , Middle Aged , Laparoscopy/statistics & numerical data , Laparoscopy/methods , Obesity/surgery , Obesity/complications , Adult , Retrospective Studies , Aged , Hysterectomy/methods , Hysterectomy/statistics & numerical data , Natural Orifice Endoscopic Surgery/methods , Young Adult , Adolescent , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Postoperative Hemorrhage/etiology , Postoperative Hemorrhage/epidemiology , Hysterectomy, Vaginal/methods , Hysterectomy, Vaginal/statistics & numerical data , Robotic Surgical Procedures/statistics & numerical dataABSTRACT
OBJECTIVES: The purpose of this study is to show the feasibility and surgical outcome of vNOTES retroperitoneal dissection and isolation of sentinel lymph nodes in overweight and obese patients with endometrial cancer. MATERIALS AND METHODS: Four patients had undergone pelvic lymphadenectomy with a sentinel lymph node. Three patients were overweight, and one was obese with a BMI of 34.6 kg/m2. By using NMR mode sentinel lymph node was visualized, excised and marked separately for pathohistological analysis from the rest of the visualized lymph nodes that were then consecutively excised. RESULTS: The mean number of overall excised lymph nodes was 12.5, and the mean number on the right side was 5.75 and 6.25 on the left side. There were no metastases verified in the pathohistological evaluation. CONCLUSION: vNOTES retroperitoneal isolation of sentinel lymph nodes is good alternative and has its benefits, especially in overweight and obese patients with satisfying low intra- and postoperative complications.
