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Laparoscopic Pectopexy—CUSUM Learning Curve and Perioperative Complications Analysis

The study aimed to examine the learning curve and perioperative complications for laparoscopic pectopexy (LP). A total of 60 women with stage II–IV apical prolapse who underwent LP were dichotomized into groups: LSH(+) with concomitant laparoscopic supracervical hysterectomy (LSH), LSH(−) after prev...

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Autores principales: Szymczak, Paulina, Grzybowska, Magdalena Emilia, Sawicki, Sambor, Wydra, Dariusz Grzegorz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7961615/
https://www.ncbi.nlm.nih.gov/pubmed/33806294
http://dx.doi.org/10.3390/jcm10051052
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author Szymczak, Paulina
Grzybowska, Magdalena Emilia
Sawicki, Sambor
Wydra, Dariusz Grzegorz
author_facet Szymczak, Paulina
Grzybowska, Magdalena Emilia
Sawicki, Sambor
Wydra, Dariusz Grzegorz
author_sort Szymczak, Paulina
collection PubMed
description The study aimed to examine the learning curve and perioperative complications for laparoscopic pectopexy (LP). A total of 60 women with stage II–IV apical prolapse who underwent LP were dichotomized into groups: LSH(+) with concomitant laparoscopic supracervical hysterectomy (LSH), LSH(−) after previous supracervical/total hysterectomy. Operative time, estimated blood loss and hospitalization length were evaluated with cumulative sum (CUSUM) analysis and the Kwiatkowski–Phillips–Schmidt–Shin (KPSS) test, separately for two surgeons (A and B). Intraoperative and perioperative complications according to the Clavien–Dindo (C–D) classification were analyzed. Mean operative time, change in hemoglobin level, and postoperative hospital stay were 143.5 ± 23.1 min—1.5 ± 0.5g/dL and 2.5 ± 0.9 days, respectively. LSH during pectopexy was associated with longer operative time (p = 0.01) but not with higher intraoperative bleeding or prolonged hospital stay. Severe complications rate was low (1.7%) with one bowel injury in LSH(−) (C–D grade IIIb). No C–D grade II, IV and V complications were found. Conversion to open pectopexy, return to the operating room or blood transfusion were not required. The KPSS test showed that a steady operative time for Surgeon A was achieved after 28 procedures. A proficiency for laparoscopic pectopexy based on CUSUM analysis was observed after 38–40 procedures.
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spelling pubmed-79616152021-03-17 Laparoscopic Pectopexy—CUSUM Learning Curve and Perioperative Complications Analysis Szymczak, Paulina Grzybowska, Magdalena Emilia Sawicki, Sambor Wydra, Dariusz Grzegorz J Clin Med Article The study aimed to examine the learning curve and perioperative complications for laparoscopic pectopexy (LP). A total of 60 women with stage II–IV apical prolapse who underwent LP were dichotomized into groups: LSH(+) with concomitant laparoscopic supracervical hysterectomy (LSH), LSH(−) after previous supracervical/total hysterectomy. Operative time, estimated blood loss and hospitalization length were evaluated with cumulative sum (CUSUM) analysis and the Kwiatkowski–Phillips–Schmidt–Shin (KPSS) test, separately for two surgeons (A and B). Intraoperative and perioperative complications according to the Clavien–Dindo (C–D) classification were analyzed. Mean operative time, change in hemoglobin level, and postoperative hospital stay were 143.5 ± 23.1 min—1.5 ± 0.5g/dL and 2.5 ± 0.9 days, respectively. LSH during pectopexy was associated with longer operative time (p = 0.01) but not with higher intraoperative bleeding or prolonged hospital stay. Severe complications rate was low (1.7%) with one bowel injury in LSH(−) (C–D grade IIIb). No C–D grade II, IV and V complications were found. Conversion to open pectopexy, return to the operating room or blood transfusion were not required. The KPSS test showed that a steady operative time for Surgeon A was achieved after 28 procedures. A proficiency for laparoscopic pectopexy based on CUSUM analysis was observed after 38–40 procedures. MDPI 2021-03-04 /pmc/articles/PMC7961615/ /pubmed/33806294 http://dx.doi.org/10.3390/jcm10051052 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Szymczak, Paulina
Grzybowska, Magdalena Emilia
Sawicki, Sambor
Wydra, Dariusz Grzegorz
Laparoscopic Pectopexy—CUSUM Learning Curve and Perioperative Complications Analysis
title Laparoscopic Pectopexy—CUSUM Learning Curve and Perioperative Complications Analysis
title_full Laparoscopic Pectopexy—CUSUM Learning Curve and Perioperative Complications Analysis
title_fullStr Laparoscopic Pectopexy—CUSUM Learning Curve and Perioperative Complications Analysis
title_full_unstemmed Laparoscopic Pectopexy—CUSUM Learning Curve and Perioperative Complications Analysis
title_short Laparoscopic Pectopexy—CUSUM Learning Curve and Perioperative Complications Analysis
title_sort laparoscopic pectopexy—cusum learning curve and perioperative complications analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7961615/
https://www.ncbi.nlm.nih.gov/pubmed/33806294
http://dx.doi.org/10.3390/jcm10051052
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