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- W4213269213 abstract "To determine the rate of concurrent colporrhaphy at the time of hysterectomy with sacrocolpopexy and the effect on perioperative outcomes. This is a retrospective cohort analysis of the National Surgical Quality Improvement Program (NSQIP) database for the years 2014 to 2019. Cases were selected by Current Procedural Terminology (CPT) codes for hysterectomy and abdominal or laparoscopic sacrocolpopexy. Exclusion criteria included hysteropexy, vaginal hysterectomy, gynecologic malignancy, and preoperative infection. Demographic variables, surgeon training, surgical characteristics, and perioperative outcomes were analyzed for four groups: (1) no concurrent colporrhaphy, (2) anterior colporrhaphy, (3) posterior colporrhaphy, and (4) combined anterior-posterior or unspecified colporrhaphy. Bivariate and multivariable regression analyses were performed. A total of 10,859 patients were included in the final analyses. Most patients did not have concurrent colporrhaphy, but this proportion decreased over time from 71.9% in 2014 to 66.5% in 2019 (p=0.029). The rate of posterior colporrhaphy increased significantly from 14.3% in 2014 to 19.0% in 2019 (p=0.002). Isolated anterior colporrhaphy remained uncommon (2.3 to 3.3%) throughout the study period. Concurrent colporrhaphy significantly increased median operative time (p<0.001) by an average of 18 minutes for anterior colporrhaphy, 37 minutes for posterior colporrhaphy, and 21 minutes for anterior-posterior or unspecified colporrhaphy. There were no significant differences between groups in rates of transfusion, wound dehiscence, surgical site infection, return to the operating room, urinary tract infection, medical complications, or 30-day readmission. Gynecologists performed more than 90% of all cases and were more likely than urologists to perform concurrent colporrhaphy (relative risk 1.99, CI 1.62-2.44). Most patients in the NSQIP database undergoing hysterectomy with sacrocolpopexy do not have a concurrent colporrhaphy. Isolated posterior colporrhaphy is more common than isolated anterior colporrhaphy. The additional procedure increases operative time; however, colporrhaphy is not associated with increase in the rate of major perioperative surgical or medical complications." @default.
- W4213269213 created "2022-02-24" @default.
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- W4213269213 date "2022-03-01" @default.
- W4213269213 modified "2023-09-24" @default.
- W4213269213 title "Rate of colporrhaphy at the time of sacrocolpopexy and impact on perioperative morbidity: a national surgical quality improvement program study" @default.
- W4213269213 doi "https://doi.org/10.1016/j.ajog.2021.12.070" @default.
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