Lesión y reparación laparoscópica de nervio obturador en linfadenectomía laparoscópica. Reporte de un caso y revisión de la literatura

Burbano-Luna, Javier; Merchán-Jiménez, Abel; Moreno-Capacho, Miguel; Pareja-Franco, René

doi:10.18597/rcog.3168

Cited by 3 publications

(1 citation statement)

References 16 publications

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“…The 149 articles were screened by titles and abstracts and then full-text articles were reviewed. The final selection of 22 articles fit the inclusion criteria and contained a total of 25 patients from 2004 to 2019 1 6 17–36…”

Section: Resultsmentioning

confidence: 99%

A systematic review of nerve grafting, end-to-end repair, and nerve transfer for obturator nerve injuries

Garg

Hassan

Ketheeswaran

et al. 2022

Int J Gynecol Cancer

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ObjectiveObturator nerve injury can occur as a complication of gynecologic surgeries, occurring most frequently in patients with endometriosis and genitourinary malignancies. The resulting injury causes paresthesia and major weakness in adduction and atrophy of the adductor group of lower extremity muscles. The objective of this study was to conduct a systematic review and meta-analysis of the effectiveness of end-to-end repair, nerve grafting, and nerve transfer in improving motor function in patients with obturator nerve injury.MethodsPubMed, Cochrane, Medline, and Embase libraries were searched from May 1994 to August 2020 according to the PRISMA guidelines for articles that present functional outcomes after obturator nerve injury in patients treated with nerve grafting, end-to-end repair, or nerve transfer.ResultsA total of 25 patients from 22 studies were included in the study, 15 of whom were treated with end-to-end repair (60%), nine with nerve grafting (36%), and one with nerve transfer (4%). Of the 15 patients with transection data, two had incomplete (13%) and 13 had complete (87%) nerve transections. The patients underwent pelvic lymphadenectomy (n=24) and radical cystectomy (n=1) operations. The mean Medical Research Council (MRC) score was 2.95±1.7 immediately after treatment and 4.77±0.6 at the final follow-up. All patients achieved good outcomes (MRC ≥3) at the final follow-up. The mean MRC score for end-to-end repair (n=15), nerve grafting (n=9), and nerve transfer (n=1) was 4.8±0.6, 4.7±0.8, and 5, respectively. Patients with end-to-end repair had higher immediate post-operative strength than those treated with nerve grafting (p=0.03) and tended to achieve full functional recovery after shorter periods of time (rho=−0.65, p=0.049). Other parameters did not correlate with MRC.ConclusionEnd-to-end repair, nerve grafting, and nerve transfer are equally effective in restoring function in patients with obturator nerve injury. However, patients treated with end-to-end repair had higher immediate post-operative strength than those treated with nerve grafting.

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Section: Resultsmentioning

confidence: 99%