We systematically searched PubMed, Embase, ClinicalTrials.gov, and the Cochrane Library Central Register of Controlled Trials for articles in which researchers compared AS with PS in SCP. The primary outcomes were the surgical success rate and suture-related complications (suture exposure/erosion, mesh erosion, and suture removal). All analyses were performed with Review Manager 5.3.
Four articles involving 689 patients were ultimately included. Our findings demonstrated that AS had similar surgical success rates to those of PS (OR=1.34; 95% CI, 0.60-2.96) and no significant differences in failure rates were noted between the two groups (OR=0.75; 95% CI, 0.34-1.66). Subgroup analyses in patients with anatomical failure revealed no significant differences in recurrent posterior prolapse (OR=0.33; 95% CI, 0.05-2.10) or in recurrent apical (OR=0.64; 95% CI, 0.03-13.66) or anterior prolapse (OR=0.45; 95% CI, 0.13-1.57). However, the AS group were at a lower risk of suture exposure/erosion (OR=0.18; 95% CI, 0.06-0.58) and a lower suture removal rate (OR=0.14; 95% CI, 0.03-0.61) and retreatment (OR=0.36; 95% CI, 0.16-0.82), but the mesh erosion was not significantly different (OR=1.00; 95% CI, 0.49-2.08).
The data showed that AS had a similar success rate, less exposure/erosion, and were less likely to be removed and require retreatment than PS, which supported the notion that AS is as effective as PS but safer.
方法:我们系统地搜索了PubMed,Embase,ClinicalTrials.gov,和Cochrane图书馆中央对照试验登记册中的文章,研究人员在SCP中比较了AS和PS。主要结果是手术成功率和缝线相关并发症(缝线暴露/侵蚀,网孔侵蚀,和缝线移除)。所有分析均使用ReviewManager5.3进行。
结果:最终纳入4篇文献,共689例患者。我们的研究结果表明,AS的手术成功率与PS相似(OR=1.34;95%CI,0.60-2.96),两组之间的失败率没有显着差异(OR=0.75;95%CI,0.34-1.66)。解剖功能衰竭患者的亚组分析显示,复发性后脱垂(OR=0.33;95%CI,0.05-2.10)或复发性根尖脱垂(OR=0.64;95%CI,0.03-13.66)或前部脱垂(OR=0.45;95%CI,0.13-1.57)没有显着差异。然而,AS组的缝合线暴露/侵蚀风险较低(OR=0.18;95%CI,0.06-0.58),缝合线去除率较低(OR=0.14;95%CI,0.03-0.61)和再治疗(OR=0.36;95%CI,0.16-0.82),但网孔侵蚀无显著差异(OR=1.00;95%CI,0.49-2.08)。
结论:数据显示AS具有相似的成功率,更少的暴露/侵蚀,与PS相比,被移除和需要再治疗的可能性较小,这支持了AS和PS一样有效但更安全的观点。