Meta-analysis of the comparison of laparoscopic pectopexy and laparoscopic sacrocolpopexy in the treatment of pelvic organ prolapse.

Abstract

The effectiveness and safety of laparoscopic pectopexy (LP) in the treatment of female pelvic organ prolapse (POP) have recently gained significant interest. This study aimed to compare the outcomes and effectiveness of LP and laparoscopic sacrocolpopexy (LSC). A comprehensive literature search was conducted across multiple databases, including PubMed, MEDLINE, Embase, Web of Science, Cochrane Library, Clinical Trials, and CNKI. No language restrictions were applied in the search. The search encompassed the entire period from the inception of the respective databases to April 2023. All randomized controlled trials and comparative studies were included. A cumulative analysis was conducted on 10 studies, accounting for 15% of the overall research pool. The sample sizes of these studies were 760. Two researchers independently evaluated the eligibility of the studies, collected the relevant data, and evaluated their potential bias. Compared with LSC, the average operation time for LP in the simple surgery group was shorter (standardized mean difference [SMD] -2.14, 95% CI -2.68 to -1.60, P < 0.001). The average bleeding volume was lower (SMD -3.17, 95% CI -5.22 to -1.12, P = 0.002), the postoperative indwelling catheterization time was shorter (SMD -0.35, 95% CI -0.67 to -0.02, P = 0.040), and there were fewer total postoperative complications (odds ratio [OR] 0.53, 95% CI 0.30-0.94, P = 0.030). In terms of effectiveness, the LP group had fewer postoperative prolapse recurrences than the LSC group (OR 0.33, 95% CI 0.14-0.77, P = 0.010). LP demonstrates a comparable surgical efficacy to LSC. However, the surgical safety of LP is significantly improved. These findings should be validated by including additional randomized controlled trials.