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[PMID]:29428038
[Au] Autor:Shubinets V; Fox JP; Lanni MA; Tecce MG; Pauli EM; Hope WW; Kovach SJ; Fischer JP
[Ti] Título:Incisional Hernia in the United States: Trends in Hospital Encounters and Corresponding Healthcare Charges.
[So] Source:Am Surg;84(1):118-125, 2018 Jan 01.
[Is] ISSN:1555-9823
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Incisional hernia (IH) is a challenging, potentially morbid condition. This study evaluates recent trends in hospital encounters associated with IH care in the United States. Using Nationwide Inpatient Sample databases from 2007 to 2011, annual estimates of IH-related hospital discharges, charges, and serious adverse events were identified. Significance in observed trends was tested using regression modeling. From 2007 to 2011, there were 583,054 hospital discharges associated with a diagnosis of IH. 81.1 per cent had a concurrent procedure for IH repair. The average discharge included a female patient (63.2%), 59.8 years of age, with either Medicare (45.3%) or Private insurance (38.3%) as the anticipated primary payer. Comparing 2007 to 2011, significant increases in IH discharges (12%; 2007 = 109,702 vs 2011 = 123,034, P = 0.009) and IH repairs (10%; 2007 = 90,588 vs 2011 = 99,622, P < 0.001) were observed. This was accompanied by a 37 per cent increase in hospital charges (2007 = $44,587 vs 2011 = $60,968, P < 0.001), resulting in a total healthcare bill of $7.3 billion in 2011. Significant trends toward greater patient age (2007 = 59.7 years vs 2011 = 60.2 years, P < 0.001), higher comorbidity index (2007 = 3.0 vs 2011 = 3.5, P < 0.001), and increased frequency of serious adverse events (2007 = 13.5% vs 2011 = 17.7%, P < 0.001) were noted. Further work is needed to identify interventions to mitigate the risk of IH development.
[Mh] Termos MeSH primário: Herniorrafia/economia
Preços Hospitalares
Hérnia Incisional/economia
Pacientes Internados
Laparoscopia/economia
Tempo de Internação/economia
Telas Cirúrgicas/economia
[Mh] Termos MeSH secundário: Custos e Análise de Custo
Feminino
Preços Hospitalares/tendências
Hospitais
Seres Humanos
Hérnia Incisional/diagnóstico
Hérnia Incisional/etiologia
Hérnia Incisional/cirurgia
Masculino
Medicare
Meia-Idade
Alta do Paciente/economia
Estudos Retrospectivos
Medição de Risco
Fatores de Risco
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180212
[St] Status:MEDLINE


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[PMID]:29428035
[Au] Autor:Lanni MA; Tecce MG; Shubinets V; Mirzabeigi MN; Fischer JP
[Ti] Título:The State of Prophylactic Mesh Augmentation.
[So] Source:Am Surg;84(1):99-108, 2018 Jan 01.
[Is] ISSN:1555-9823
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Prophylactic mesh augmentation (PMA) is the implantation of mesh during closure of an index laparotomy to decrease a patient's risk for developing incisional hernia (IH). The current body of evidence lacks refined guidelines for patient selection, mesh placement, and material choice. The purpose of this study is to summarize the literature and identify areas of research needed to foster responsible and appropriate use of PMA as an emerging technique. We conducted a comprehensive review of Scopus, Cochrane, PubMed, and clinicaltrials.gov for articles and trials related to using PMA for IH risk reduction. We further supplemented our review by including select papers on patient-reported outcomes, cost utility, risk modeling, surgical techniques, and available materials highly relevant to PMA. Five-hundred-fifty-one unique articles and 357 trials were reviewed. Multiple studies note a significant decrease in IH incidence with PMA compared with primary suture-only-based closure. No multicenter randomized control trial has been conducted in the United States, and only two such trials are currently active worldwide. Evidence exists supporting the use of PMA, with practical cost utility and models for selecting high-risk patients, but standard PMA guidelines are lacking. Although Europe has progressed with this technique, widespread adoption of PMA requires large-scale pragmatic randomized control trial research, strong evidence-based guidelines, current procedural terminology coding, and resolution of several barriers.
[Mh] Termos MeSH primário: Hérnia Ventral/cirurgia
Hérnia Incisional/etiologia
Hérnia Incisional/prevenção & controle
Laparotomia
Telas Cirúrgicas
[Mh] Termos MeSH secundário: Ensaios Clínicos como Assunto
Medicina Baseada em Evidências
Hérnia Ventral/economia
Seres Humanos
Hérnia Incisional/economia
Laparotomia/métodos
Fatores de Risco
Telas Cirúrgicas/economia
Técnicas de Sutura
Fatores de Tempo
Resultado do Tratamento
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180212
[St] Status:MEDLINE


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[PMID]:29217786
[Au] Autor:Heneghan C; Aronson JK; Goldacre B; Mahtani KR; Plüddemann A; Onakpoya I
[Ad] Endereço:Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK carl.heneghan@phc.ox.ac.uk.
[Ti] Título:Transvaginal mesh failure: lessons for regulation of implantable devices.
[So] Source:BMJ;359:j5515, 2017 12 07.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Aprovação de Equipamentos/normas
Prolapso de Órgão Pélvico/cirurgia
Telas Cirúrgicas/normas
Incontinência Urinária/cirurgia
[Mh] Termos MeSH secundário: Feminino
Procedimentos Cirúrgicos em Ginecologia/instrumentação
Procedimentos Cirúrgicos em Ginecologia/legislação & jurisprudência
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171209
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j5515


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[PMID]:29390579
[Au] Autor:Yin XH; Liu ZK; He BR; Hao DJ
[Ad] Endereço:Department of Spine Surgery, Hong Hui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, China.
[Ti] Título:Single posterior surgical management for lumbosacral tuberculosis: titanium mesh versus iliac bone graft: A retrospective case-control study.
[So] Source:Medicine (Baltimore);96(51):e9449, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Recently, the one-stage posterior approach for treating spinal tuberculosis (TB) has gained popularity. However, large bony defects after debridement remain a major challenge in posterior surgery. The present retrospective study aims to compare the clinical outcomes of posterior-only surgical management by titanium mesh versus iliac bone grafts for treating lumbosacral TB. This was a retrospective cohort study. From January 2006 to April 2012, 36 patients with lumbosacral TB were treated at our department. The 36 cases were divided into 2 groups: 17 patients in Group A (titanium mesh) underwent one-stage posterior internal fixation, debridement, and titanium mesh bone fusion. The 19 patients in Group B (iliac bone graft) underwent posterior instrumentation, debridement, and iliac bone graft in a single procedure. The clinical and radiographic results for the 2 groups were analyzed and compared. The mean year of patients was 49.9 ±â€Š15.4 months in group A and 55.5 ±â€Š12.6 months in group B. All patients were followed up for an average of 47.3 ±â€Š8.1 months (range 36-60 months). Spinal TB was completely cured and no intraspinal infection and central nervous system complications of TB infection occurred. Bone fusion was achieved 6.4 ±â€Š1.9 months in group A and 7.8 ±â€Š2.1 months in group B. There was no significant statistical difference in bone fusion between the 2 groups (P > .05). The Oswestry Disability Index score (ODI) significantly improved between the preoperative and the last visit in either group. However, no significant difference was observed between the 2 groups at last visit (P > .05). There were significant differences between groups regarding the postoperative lumbosacral angle and angle correction loss at the final follow-up (P < .05). The average operative complication rate of Group A was less than that of Group B. Both iliac bone and titanium mesh can effectively construct anterior column defects in posterior surgery. The titanium mesh has the advantage of minor surgical invasion, effective reconstruction of large defects, and ideal sagittal alignment in lumbosacral TB for patients with osteoporosis and poor iliac bone quality.
[Mh] Termos MeSH primário: Transplante Ósseo/métodos
Ílio/transplante
Região Lombossacral/cirurgia
Telas Cirúrgicas
Tuberculose da Coluna Vertebral/cirurgia
[Mh] Termos MeSH secundário: Transplante Ósseo/instrumentação
Estudos de Casos e Controles
Feminino
Seres Humanos
Vértebras Lombares/microbiologia
Vértebras Lombares/cirurgia
Região Lombossacral/microbiologia
Masculino
Meia-Idade
Estudos Retrospectivos
Sacro/microbiologia
Sacro/cirurgia
Titânio
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
D1JT611TNE (Titanium)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180212
[Lr] Data última revisão:
180212
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009449


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[PMID]:27778058
[Au] Autor:Michalski CW; Tramelli P; Büchler MW; Hackert T
[Ad] Endereço:Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland.
[Ti] Título:[Closure of pancreas stump after distal and segmental resection : Suture, stapler, coverage or anastomosis?]
[Ti] Título:Verschluss des Pankreasstumpfes bei Links- und Segmentresektion : Naht, Stapler, Deckung oder Anastomose?.
[So] Source:Chirurg;88(1):25-29, 2017 Jan.
[Is] ISSN:1433-0385
[Cp] País de publicação:Germany
[La] Idioma:ger
[Ab] Resumo:Postoperative pancreatic fistulas represent the most frequent complication after distal and segmental pancreatectomy and occur with a frequency of up to 50 %. There are many technical variations of pancreatic stump treatment for reduction of fistula rates after distal resection. Most of these techniques have only been analyzed in retrospective studies and the evidence for or against a specific technique is low. Several retrospective trials have been conducted with good results to compare suturing with stapled closure of the remnant and to assess the effect of a vascularized falciform ligament patch in reducing postoperative pancreatic fistula; however, in a recently published randomized trial, which analyzed closure of the remnant with a pancreaticojejunostomy compared to standard closure, these results could not be confirmed. Because stapler resection and closure is the most commonly used technique in laparoscopic distal pancreatectomy, there are a large number of studies which assessed various novel methods of improving stapling. Extended stapler compression time and mesh augmentation of the stapler line can be valid methods to reduce fistula rates. Central pancreatectomy is a relatively rarely used procedure where the right-sided pancreatic remnant is closed in the same fashion as during distal pancreatectomy and the left-sided remnant is connected to the intestines with a pancreaticojejunostomy or pancreaticogastrostomy. In conclusion, postoperative pancreatic fistula rates are still a relevant clinical problem after distal pancreatectomy and further studies on potentially improved novel techniques are required.
[Mh] Termos MeSH primário: Anastomose Cirúrgica/métodos
Pancreatectomia/métodos
Fístula Pancreática/prevenção & controle
Complicações Pós-Operatórias/prevenção & controle
Grampeamento Cirúrgico/métodos
Técnicas de Sutura
[Mh] Termos MeSH secundário: Combinação de Medicamentos
Adesivo Tecidual de Fibrina/administração & dosagem
Fibrinogênio/administração & dosagem
Seres Humanos
Pancreaticojejunostomia/métodos
Fatores de Risco
Ligamento Redondo do Fígado/cirurgia
Telas Cirúrgicas
Trombina/administração & dosagem
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Drug Combinations); 0 (Fibrin Tissue Adhesive); 0 (TachoSil); 9001-32-5 (Fibrinogen); EC 3.4.21.5 (Thrombin)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180209
[Lr] Data última revisão:
180209
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE
[do] DOI:10.1007/s00104-016-0301-3


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[PMID]:29240749
[Au] Autor:Bendavid R
[Ad] Endereço:Surgery, Shouldice Hospital, Thornhill, Canada.
[Ti] Título:Mesh abdominal wall hernia surgery is safe and effective-the harm New Zealand media has done: response to Dr Steven Kelly's article.
[So] Source:N Z Med J;130(1467):97-98, 2017 12 15.
[Is] ISSN:1175-8716
[Cp] País de publicação:New Zealand
[La] Idioma:eng
[Mh] Termos MeSH primário: Parede Abdominal/cirurgia
Hérnia Ventral/cirurgia
[Mh] Termos MeSH secundário: Hérnia Abdominal/cirurgia
Herniorrafia
Seres Humanos
Meios de Comunicação de Massa
Nova Zelândia
Telas Cirúrgicas
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180205
[Lr] Data última revisão:
180205
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE


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ARANA-CHAVEZ, Victor Elias
Texto completo SciELO Brasil
[PMID]:29236898
[Au] Autor:Carnaval TG; Gonçalves F; Romano MM; Catalani LH; Mayer MAP; Arana-Chávez VE; Nishida AC; Lage TC; Francci CE; Adde CA
[Ad] Endereço:Universidade de São Paulo - USP, Dental School, Department of Stomatology, São Paulo, SP, Brazil.
[Ti] Título:In vitro analysis of a local polymeric device as an alternative for systemic antibiotics in Dentistry.
[So] Source:Braz Oral Res;31:e92, 2017 Dec 07.
[Is] ISSN:1807-3107
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:The development of a biodegradable material with antimicrobial properties for local applications is required in the prevention and treatment of infectious diseases. The objective of this study was to produce blends of poly-L-lactide acid (PLLA) synthetic polymer associated with several antimicrobials, as an alternative in the prevention and treatment of infections, as well as to evaluate its cytotoxicity, release of antimicrobials and inhibit bacteria growth. Blends of PLLA added with 20% Amoxicillin, Metronidazole, Clindamycin or Azithromicyn were used to produce Films (F) or Meshs (M) by casting and electrospinning methods, respectively. Standardized discs of the films and meshs were stored in buffer solutions (pH 5 or 7.4) and aliquots were analyzed by high performance chromatography (HPLC) during 168 hours. Cytotoxicity on human gingival fibroblasts was tested after 24, 48 and 72h by MTT reaction. The antimicrobial capacity was determined against P. gingivalis and S. pyogenes. The specimens were weighed after 3 and 6 months of storage for degradation analysis. SEM was performed to control interfaces and degradation. Antimicrobials presented a continuous and exponential drug release. Analysis showed that both M and F were able to inhibit S. pyogenes and P. gingivalis growth, indicating the release of active antimicrobial agents. The products were not toxic to the fibroblasts. Amoxicillin-film showed more degradation than PLLA at both pHs (p < 0.05), whereas Azithromycin-meshes were more degraded than PLLA at pH 7.4 (p < 0.05). PLLA association with antimicrobials is biocompatible and may represent a potential tool for the local delivery of antimicrobials.
[Mh] Termos MeSH primário: Anti-Infecciosos/farmacologia
Materiais Biocompatíveis/farmacologia
Viabilidade Microbiana/efeitos dos fármacos
Poliésteres/farmacologia
Polímeros/farmacologia
Porphyromonas gingivalis/efeitos dos fármacos
Streptococcus pyogenes/efeitos dos fármacos
[Mh] Termos MeSH secundário: Anti-Infecciosos/química
Materiais Biocompatíveis/química
Técnicas de Cultura de Células
Combinação de Medicamentos
Seres Humanos
Teste de Materiais
Polímeros/química
Telas Cirúrgicas
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Infective Agents); 0 (Biocompatible Materials); 0 (Drug Combinations); 0 (Polyesters); 0 (Polymers); 459TN2L5F5 (poly(lactide))
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180117
[Lr] Data última revisão:
180117
[Sb] Subgrupo de revista:D; IM
[Da] Data de entrada para processamento:171214
[St] Status:MEDLINE


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[PMID]:29280882
[Au] Autor:Patel NG; Ratanshi I; Buchel EW
[Ad] Endereço:Leicester, United Kingdom; and Winnipeg, Manitoba, Canada From the Department of Plastic Surgery, Leicester Royal Infirmary, University Hospitals of Leicester; and the Department of Surgery, Section of Plastic Surgery, Health Sciences Center, University of Manitoba.
[Ti] Título:The Best of Abdominal Wall Reconstruction.
[So] Source:Plast Reconstr Surg;141(1):113e-136e, 2018 01.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:LEARNING OBJECTIVES: After reviewing this article, the participant should be able to: 1. List major risk factors for hernia formation and for failure of primary repair. 2. Outline an algorithmic approach to anterior abdominal wall reconstruction based on the degree of contamination, components involved in the deficit, and width of the hernia defect. 3. Describe appropriate indications for synthetic and biological mesh products. 4. List common flaps used in anterior abdominal wall reconstruction, including functional restoration strategies. 5. Describe the current state of the art of vascularized composite tissue allotransplantation strategies for abdominal wall reconstruction. SUMMARY: Plastic surgeons have an increasingly important role in abdominal wall reconstruction-from recalcitrant, large incisional hernias to complete loss of abdominal wall domain. A review of current algorithms is warranted to match evolving surgical techniques and a growing number of available implant materials. The purpose of this article is to provide an updated review of treatment strategies to provide an approach to the full spectrum of abdominal wall deficits encountered in the modern plastic surgery practice.
[Mh] Termos MeSH primário: Parede Abdominal/cirurgia
Hérnia Ventral/cirurgia
Herniorrafia/métodos
[Mh] Termos MeSH secundário: Parede Abdominal/anatomia & histologia
Técnicas de Fechamento de Ferimentos Abdominais
Cirurgia Bariátrica
Aloenxertos Compostos
Hérnia Ventral/diagnóstico
Seres Humanos
Reoperação
Transplante de Pele
Retalhos Cirúrgicos
Telas Cirúrgicas
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW; VIDEO-AUDIO MEDIA
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180112
[Lr] Data última revisão:
180112
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171228
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003976


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[PMID]:29184050
[Au] Autor:Susmallian S; Raziel A
[Ad] Endereço:Department of Surgery, Assuta Medical Center, Tel Aviv, Israel.
[Ti] Título:A Rare Case of Bochdalek Hernia with Concomitant Para-Esophageal Hernia, Repaired Laparoscopically in an Octogenarian.
[So] Source:Am J Case Rep;18:1261-1265, 2017 Nov 29.
[Is] ISSN:1941-5923
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND A Bochdalek hernia (BH) is a rare congenital condition consisting of a posterolateral defect in the diaphragm. A para-esophageal hernia (PEH) is a rare variant of hiatus hernia. BH and PEH may present with gastric volvulus or incarceration, requiring emergency treatment. Minimally invasive surgery is the preferred treatment, particularly for elderly patients and patients with comorbidities. The occurrence of BH with concomitant PEH is a very rare event. We describe a case of an octogenarian patient with BH and concomitant PEH treated laparoscopically. CASE REPORT An 81-year-old male patient, without significant comorbidities, presented with a two-month history of severe chest pain and vomiting after eating. Cardiological investigations ruled out cardiac ischemia, infarction, or other cardiovascular abnormalities. Chest and abdominal computed tomography (CT) imaging demonstrated a large diaphragmatic hernia, with the entire stomach in the left thorax. Laboratory results showed mild anemia and a low iron level. The patient underwent simultaneous laparoscopic repair of a BH and a PEH with mesh reinforcement without antireflux fundoplication. The patient's postoperative recovery was uneventful. CONCLUSIONS We have presented a rare case of BH with concomitant PEH in an octogenarian that was successfully treated with laparoscopic surgery. Although these two forms of hernia are a very rare association, this case report illustrates that the surgical approach should be individualized in each patient's case to ensure a successful surgical outcome. In this case, the decision was made to suture the diaphragmatic crura and reinforce the diaphragm repair with mesh, rather than by fundoplication.
[Mh] Termos MeSH primário: Hérnia Hiatal/complicações
Hérnia Hiatal/cirurgia
Hérnias Diafragmáticas Congênitas/complicações
Hérnias Diafragmáticas Congênitas/cirurgia
Laparoscopia
[Mh] Termos MeSH secundário: Idoso de 80 Anos ou mais
Hérnia Hiatal/diagnóstico por imagem
Hérnias Diafragmáticas Congênitas/diagnóstico por imagem
Seres Humanos
Masculino
Doenças Raras
Telas Cirúrgicas
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180109
[Lr] Data última revisão:
180109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171130
[St] Status:MEDLINE


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[PMID]:29215517
[Au] Autor:Trabuco EC; Linder BJ; Klingele CJ; Blandon RE; Occhino JA; Weaver AL; McGree ME; Gebhart JB
[Ad] Endereço:Divisions of Gynecologic Surgery and Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota; and the Department of Obstetrics and Gynecology, University of Missouri, Kansas City, Missouri.
[Ti] Título:Two-Year Results of Burch Compared With Midurethral Sling With Sacrocolpopexy: A Randomized Controlled Trial.
[So] Source:Obstet Gynecol;131(1):31-38, 2018 Jan.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate 1- and 2-year urinary continence rates after Burch retropubic urethropexy compared with a retropubic midurethral sling for women with urinary incontinence undergoing sacrocolpopexy. METHODS: We conducted a planned secondary analysis of a multicenter, randomized, single-blind trial comparing Burch with a sling that enrolled participants from June 2009 to August 2013. Objective outcome measures of continence were assessed at 1- and 2-year follow-up through office visits and validated questionnaires. Overall continence was defined as a negative stress test, no retreatment for stress incontinence, and no self-reported urinary incontinence (International Consultation on Incontinence Questionnaire, Short Form, score, 0). Stress-specific continence was defined as fulfillment of the first two criteria and no self-reported stress-related incontinence. Primary outcomes were assessed with intention-to-treat and within-protocol analyses. Comparisons between groups were evaluated using χ or Fisher exact test. RESULTS: The two groups were similar in all measured baseline features. Outcome assessments at 2 years were available for 48 of 57 patients (84%) in the sling group and 45 of 56 patients (80%) in the Burch group. With intention-to-treat analysis, the sling group had significantly higher rates of overall continence than the Burch group (49% [28/57] vs 29% [16/56]; 95% CI for absolute risk difference 3.0-38.1; P=.03) at 1- but not 2-year follow-up (47% [27/57] vs 32% [18/56]; 95% CI for absolute risk difference -2.6 to 33.1; P=.10). The sling group had significantly higher rates of stress-specific continence than the Burch group at 1-year (70% [40/57] vs 46% [26/56]; 95% CI for absolute risk difference 6.1-41.4; P=.01) and 2-year (70% [40/57] vs 45% [25/56]; 95% CI for absolute risk difference 7.9-43.2; P=.006) follow-up. No difference was detected in prolapse recurrence, voiding dysfunction, antimuscarinic medication use, urgency incontinence, or patient satisfaction. CONCLUSION: Among women with baseline urinary incontinence undergoing sacrocolpopexy, the retropubic midurethral sling resulted in higher stress-specific continence rates than Burch retropubic urethropexy at 1- and 2-year follow-up.
[Mh] Termos MeSH primário: Colposcopia/métodos
Qualidade de Vida
Slings Suburetrais
Incontinência Urinária por Estresse/cirurgia
Incontinência Urinária de Urgência/cirurgia
[Mh] Termos MeSH secundário: Idoso
Feminino
Seguimentos
Seres Humanos
Meia-Idade
Satisfação do Paciente/estatística & dados numéricos
Medição de Risco
Índice de Gravidade de Doença
Método Simples-Cego
Telas Cirúrgicas
Fatores de Tempo
Resultado do Tratamento
Uretra/cirurgia
Incontinência Urinária por Estresse/diagnóstico
Incontinência Urinária de Urgência/diagnóstico
Urodinâmica
Procedimentos Cirúrgicos Urológicos/métodos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171208
[St] Status:MEDLINE
[do] DOI:10.1097/AOG.0000000000002415



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