title: Safety and perioperative morbidity of laparoscopic sacropexy: a systematic analysis and a comparison with laparoscopic hysterectomy.
abstract: OBJECTIVE
  The high prevalence of Pelvic Organ Prolapse (POP) along with the demographic trend of the ageing population raises the value of sacropexy in the treatment of POP. Thus, efforts to decrease risks associated with this procedure have the potential for public health impact. We examined the perioperative morbidity of laparoscopic sacropexy regarding the surgical access and compared it with the morbidity of one of the most common gynecological procedure, the laparoscopic hysterectomy. Our aim was to prove the safety of laparoscopic sacropexy.
  
  
  METHODS
  A retrospective evaluation of 80 consecutive laparoscopic sacropexies performed from Sept. 2012 until Oct. 2014 and 126 laparoscopic hysterectomies for a benign indication were undertaken. We assessed the anatomical outcome and the intra- and postoperative complications using the classification system according to Clavien-Dindo (CD).
  
  
  RESULTS
  Apical success rate after sacropexy was 100% and global success rate was 95% (POP-Q stage ≤1). The decline in hemoglobin was low in both groups and showed no statistically significant differences. Both operative time (P < 0.001) and the duration of hospitalization (P < 0.001) were longer in case of a sacropexy. Although overall intraoperative complications seemed more frequent during a sacropexy, differences were not statistically significant. Both early and late postoperative complications showed a higher rate of mild complications (CD-I/II) and a lower rate of severe complications (CD-IIIa/IIIb) after a sacropexy. The differences were not statistically significant.
  
  
  CONCLUSIONS
  The laparoscopic sacropexy represents a safe procedure with good anatomical outcome. Despite higher technical severity, it doesn't seem to bare higher risks for perioperative morbidity than the laparoscopic hysterectomy does.
authors.affiliation: Frauenklinik und Poliklinik, Universitätsklinikum Würzburg, Josef-Schneider-Str. 4, Haus C15, 97080, Würzburg, Germany. joukhadar_r@ukw.de.|Klinik für Frauenheilkunde, Geburtshilfe und Reproduktionsmedizin, Universitätsklinikum des Saarlandes, Homburg, Germany. joukhadar_r@ukw.de.
authors.forename: R
authors.initials: R
authors.lastname: Joukhadar
authors.affiliation: Campus Lübeck Abteilung für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Lübeck, Germany.|Klinik für Frauenheilkunde, Geburtshilfe und Reproduktionsmedizin, Universitätsklinikum des Saarlandes, Homburg, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Baum
authors.affiliation: Klinik für Frauenheilkunde, Geburtshilfe und Reproduktionsmedizin, Universitätsklinikum des Saarlandes, Homburg, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Radosa
authors.affiliation: Klinik für Frauenheilkunde, Geburtshilfe und Reproduktionsmedizin, Universitätsklinikum des Saarlandes, Homburg, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Gerlinger
authors.affiliation: Klinik für Frauenheilkunde, Geburtshilfe und Reproduktionsmedizin, Universitätsklinikum des Saarlandes, Homburg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Hamza
authors.affiliation: Klinik für Frauenheilkunde, Geburtshilfe und Reproduktionsmedizin, Universitätsklinikum des Saarlandes, Homburg, Germany.
authors.forename: I
authors.initials: I
authors.lastname: Juhasz-Böss
authors.affiliation: Klinik für Frauenheilkunde, Geburtshilfe und Reproduktionsmedizin, Universitätsklinikum des Saarlandes, Homburg, Germany.
authors.forename: E-F
authors.initials: EF
authors.lastname: Solomayer
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D007431:Intraoperative Complications / Q000453:epidemiology; D010535:Laparoscopy / Q000009:adverse effects*; D008875:Middle Aged; D061646:Operative Time; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies
keywords: Laparoscopic colposacropexy; Laparoscopic sacropexy; PVDF-Mesh; Pelvic organ prolapse (POP); Perioperative morbidity; Urogynecological surgery