Shannon VanderPas Lamb1, Jason Massengill, Michael J Sheridan, Lawrence E Stern, Walter von Pechmann. 1. From the *Division of Urogynecology, Walter Reed National Military Medical Center, Bethesda, MD; †Department of Obstetrics and Gynecology, Wright Patterson Medical Center, Dayton, OH; ‡Department of Biostatistics, §Section of Colorectal Surgery, and ∥Division of Urogynecology, Inova Fairfax Medical Campus, Falls Church, VA.
Abstract
OBJECTIVES: This study aimed to determine if abdominal sacral colpopexy (ASC) using mesh can be safely combined with sigmoid resection and anastomosis. METHODS: This is a single institution, retrospective chart review of patients who underwent combined ASC and suture rectopexy with sigmoid resection between January 1, 2007, and December 31, 2011. Charts were screened for outcome data and complications related to the placement of synthetic mesh at the time of bowel resection to include readmission and reoperation rates, infection, bowel obstruction, fistula, and mesh erosion. Outcome data for patients receiving combined procedures were compared to 2 separate cohorts of patients as follows: a group that underwent only ASC with polypropylene mesh and a group that underwent only sigmoid resection plus or minus suture rectopexy. The DINDO surgical classification system was used for each cohort to further analyze complications. RESULTS: There were 133 patients in the ASC only group (ASC only), 34 in the combined ASC and sigmoid resection group (Combined), and 27 in the sigmoidectomy plus rectopexy group (Colorectal only). The Colorectal only cohort had a higher rate of postoperative ileus; ASC only 3.8%, Combined 5.9%, Colorectal 22.2% (P = 0.004). There were otherwise no differences in intraoperative and postoperative complications or in the DINDO classification scores. CONCLUSIONS: Abdominal sacral colpopexy with placement of synthetic mesh at the time of sigmoid resection and anastomosis does not seem to increase the rate of intraoperative or postoperative complications.
OBJECTIVES: This study aimed to determine if abdominal sacral colpopexy (ASC) using mesh can be safely combined with sigmoid resection and anastomosis. METHODS: This is a single institution, retrospective chart review of patients who underwent combined ASC and suture rectopexy with sigmoid resection between January 1, 2007, and December 31, 2011. Charts were screened for outcome data and complications related to the placement of synthetic mesh at the time of bowel resection to include readmission and reoperation rates, infection, bowel obstruction, fistula, and mesh erosion. Outcome data for patients receiving combined procedures were compared to 2 separate cohorts of patients as follows: a group that underwent only ASC with polypropylene mesh and a group that underwent only sigmoid resection plus or minus suture rectopexy. The DINDO surgical classification system was used for each cohort to further analyze complications. RESULTS: There were 133 patients in the ASC only group (ASC only), 34 in the combined ASC and sigmoid resection group (Combined), and 27 in the sigmoidectomy plus rectopexy group (Colorectal only). The Colorectal only cohort had a higher rate of postoperative ileus; ASC only 3.8%, Combined 5.9%, Colorectal 22.2% (P = 0.004). There were otherwise no differences in intraoperative and postoperative complications or in the DINDO classification scores. CONCLUSIONS: Abdominal sacral colpopexy with placement of synthetic mesh at the time of sigmoid resection and anastomosis does not seem to increase the rate of intraoperative or postoperative complications.