Navegando por Palavras-chave "Tela biológica"

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    Tratamento cirúrgico da distopia de parede vaginal anterior: comparação entre tela biológica e colporrafia tradicional
    (Universidade Federal de São Paulo (UNIFESP), 2010-11-25) Feldner Junior, Paulo Cezar [UNIFESP]; Girão, Manoel João Batista Castello [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objective: the aim of this study was to evaluate anatomical, functional results and complications of small intestine submucosa (SIS) graft compared to traditional anterior repair in surgical treatment of anterior vaginal wall prolapse. Methods: This is a randomized and prospective study to compare the SIS graft with traditional colporrhaphy (TC) in surgical treatment of anterior vaginal prolapse. Subjects were randomized to SIS (n=29) or to TC (n=27) and compared preoperatively and at 6 months postoperatively. We used pelvic organ quantification system (POP-Q), a validated prolapse quality of life questionnaire (P-QoL) and possible complications. Data were compared using the Mann–Whitney test or a chi-squared test to determine that there were no significant intergroup differences. This then enabled us to use the independent samples t-test or the paired Student’s t-test. This study was approved by Local Ethics Committee and register at ClinicalTrials NCT00827528. Results: the outcomes represent the analysis of 29 patients in SIS group and 27 in traditional repair. Both groups were paired by age, parity, body mass index, stage of anterior prolapse, previous surgery for prolapse, presence of incontinence, POP-Q measurements and quality of life preoperatively. At 6-month follow-up, SIS group have 86.2% anatomic cure comparing with 59.3% in traditional repair, using the International Continence Society (ICS) patterns. We did not report differences between the techniques when we divided the stage II. The mean point Ba preoperatively in SIS group was +2.07 cm and +2.22 cm in traditional repair and postoperatively -1.93 cm (p<0.001) and -1.37 cm (p<0.001), respectively. The NNT (Number Need to Treat) was 4. Both operations significantly improved prolapse quality-of-life severity measures. Although SIS group did not showed significant improvement in quality-of-life parameters measured in comparison to traditional repair. Excessive bleeding occurred in 4 patients in SIS group although none required blood transfusion. We reported more complications in SIS group (20 vs 9, p=0.01) and longer surgical time (48.3min ±16.1 vs 30.3min ±19.4; p=0.001). The average hospital length was 3.3 and 3.2 days, respectively. We did not reported infections or erosion of the mesh. Conclusions: Surgery for vaginal prolapse results in marked improvement in prolapse quality of life. We could see that SIS repair improved point Ba measurement significantly using the ICS patterns. Regarding quality-of-life parameters we did not observe significant differences in both techniques.