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Factors associated with intraoperative conversion during robotic sacrocolpopexy

OBJECTIVE: To evaluate for potential predictors of intraoperative conversion from robotic sacrocolpopexy (RSC) to open abdominal sacrocolpopexy. PATIENTS AND METHODS: We identified 83 consecutive patients from 2002-2012 with symptomatic high-grade post-hysterectomy vaginal vault prolapse that underw...

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Autores principales: Linder, Brian J., Chow, George K., Hertzig, Lindsay L., Clifton, Marisa, Elliott, Daniel S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Urologia 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752096/
https://www.ncbi.nlm.nih.gov/pubmed/26005974
http://dx.doi.org/10.1590/S1677-5538.IBJU.2015.02.19
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author Linder, Brian J.
Chow, George K.
Hertzig, Lindsay L.
Clifton, Marisa
Elliott, Daniel S.
author_facet Linder, Brian J.
Chow, George K.
Hertzig, Lindsay L.
Clifton, Marisa
Elliott, Daniel S.
author_sort Linder, Brian J.
collection PubMed
description OBJECTIVE: To evaluate for potential predictors of intraoperative conversion from robotic sacrocolpopexy (RSC) to open abdominal sacrocolpopexy. PATIENTS AND METHODS: We identified 83 consecutive patients from 2002-2012 with symptomatic high-grade post-hysterectomy vaginal vault prolapse that underwent RSC. Multiple clinical variables including patient age, comorbidities (body-mass index [BMI], hypertension, diabetes mellitus, tobacco use), prior intra-abdominal surgery and year of surgery were evaluated for potential association with conversion. RESULTS: Overall, 14/83 cases (17%) required conversion to an open sacrocolpopexy. Patients requiring conversion were found to have a significantly higher BMI compared to those who did not (median 30.2kg/m(2) versus 25.8kg/m(2); p=0.003). Other medical and surgical factors evaluated were similar between the cohorts. When stratified by increasing BMI, conversion remained associated with an increased BMI. That is, conversion occurred in 3.8% (1/26) of patients with BMI ≤25 kg/m(2), 14.7% (5/34) with BMI 25-29.9 kg/m(2) and 34.7% (8/23) with BMI ≥30 kg/m(2) (p=0.004). When evaluated as a continuous variable, BMI was also associated with a significantly increased risk of conversion to an open procedure (OR 1.18, p=0.004). CONCLUSIONS: Higher BMI was the only clinical factor associated with a significantly increased risk of intra-operative conversion during robotic sacrocolpopexy. Recognition of this may aid in pre-operative counseling and surgical patient selection.
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spelling pubmed-47520962016-05-09 Factors associated with intraoperative conversion during robotic sacrocolpopexy Linder, Brian J. Chow, George K. Hertzig, Lindsay L. Clifton, Marisa Elliott, Daniel S. Int Braz J Urol Original Article OBJECTIVE: To evaluate for potential predictors of intraoperative conversion from robotic sacrocolpopexy (RSC) to open abdominal sacrocolpopexy. PATIENTS AND METHODS: We identified 83 consecutive patients from 2002-2012 with symptomatic high-grade post-hysterectomy vaginal vault prolapse that underwent RSC. Multiple clinical variables including patient age, comorbidities (body-mass index [BMI], hypertension, diabetes mellitus, tobacco use), prior intra-abdominal surgery and year of surgery were evaluated for potential association with conversion. RESULTS: Overall, 14/83 cases (17%) required conversion to an open sacrocolpopexy. Patients requiring conversion were found to have a significantly higher BMI compared to those who did not (median 30.2kg/m(2) versus 25.8kg/m(2); p=0.003). Other medical and surgical factors evaluated were similar between the cohorts. When stratified by increasing BMI, conversion remained associated with an increased BMI. That is, conversion occurred in 3.8% (1/26) of patients with BMI ≤25 kg/m(2), 14.7% (5/34) with BMI 25-29.9 kg/m(2) and 34.7% (8/23) with BMI ≥30 kg/m(2) (p=0.004). When evaluated as a continuous variable, BMI was also associated with a significantly increased risk of conversion to an open procedure (OR 1.18, p=0.004). CONCLUSIONS: Higher BMI was the only clinical factor associated with a significantly increased risk of intra-operative conversion during robotic sacrocolpopexy. Recognition of this may aid in pre-operative counseling and surgical patient selection. Sociedade Brasileira de Urologia 2015 /pmc/articles/PMC4752096/ /pubmed/26005974 http://dx.doi.org/10.1590/S1677-5538.IBJU.2015.02.19 Text en http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Linder, Brian J.
Chow, George K.
Hertzig, Lindsay L.
Clifton, Marisa
Elliott, Daniel S.
Factors associated with intraoperative conversion during robotic sacrocolpopexy
title Factors associated with intraoperative conversion during robotic sacrocolpopexy
title_full Factors associated with intraoperative conversion during robotic sacrocolpopexy
title_fullStr Factors associated with intraoperative conversion during robotic sacrocolpopexy
title_full_unstemmed Factors associated with intraoperative conversion during robotic sacrocolpopexy
title_short Factors associated with intraoperative conversion during robotic sacrocolpopexy
title_sort factors associated with intraoperative conversion during robotic sacrocolpopexy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752096/
https://www.ncbi.nlm.nih.gov/pubmed/26005974
http://dx.doi.org/10.1590/S1677-5538.IBJU.2015.02.19
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