Is laparoscopic ventral rectopexy a good treatment option for rectal prolapse?

Yıl 2022, Cilt: 4 Sayı: 1, 108 - 112, 24.01.2022

Tezcan Akın , Sadettin Er , Hüseyin Berkem , Erdinç Çetinkaya , Elif Nur Gencer Gizem Güneş , Ahmet Keşşaf Aşlar Bülent Cavit Yüksel

https://doi.org/10.38053/acmj.1034966

Öz

Aim: Laparoscopic ventral rectopexy (LVR) is one of the most commonly performed procedures in the treatment of rectal prolapse (RP). This study aimed to evaluate postoperative changes in the incontinence status and short-term functional outcomes of patients with RP who underwent LVR.
Material and Method: This study included 15 patients who underwent LRV with the diagnosis of RP between January 2017 and June 2021 at Health Sciences University Ankara Numune Training and Research Hospital and Ankara City Hospital. Data were obtained by retrospectively examining the electronic records of the patients. The Wexner incontinence score (WIS) was calculated preoperatively and postoperatively by contacting the patients by phone at six months after the operation. In addition, the constipation status of the patients and whether they had recurrence of RP were questioned.
Results: The mean age of the 15 patients included in the study was 55 (range, 30-81) years. Twelve (80%) patients were female and three (20%) were male. When the preoperative and postoperative WISs of the patients were compared, the latter was statistically significantly lower than the former (p=0.002). Among the 10 (66.7%) patients who had constipation in the preoperative period, this complaint was resolved in four (40%), but new-onset constipation was detected in two (40%) of the five (33.3%) patients without preoperative constipation. The recurrence of RP was observed in only one (6.7%) patient in the postoperative follow-up.
Conclusion: Considering the short-term outcomes in the patients who underwent LRV for RP, it can be concluded that LVR is a good option in this patient group, with a low recurrence rate and satisfactory improvement in incontinence.

Anahtar Kelimeler

Rectal prolapsus, Laparoscopic ventral rectopexy, Incontinence, Constipation

Proje Numarası

yok

Kaynakça

• Soare C, Lasithiotakis K, Dearden H, Singh S, McNaught C. The surgical management of rectal prolapse. Indian J Surg 2020: 1-7.
• Samaranayake C, Luo C, Plank A, Merrie A, Plank L, Bissett I. Systematic review on ventral rectopexy for rectal prolapse and intussusception. Colorectal Dis 2010; 12: 504-12.
• Emile SH, Elfeki H, Shalaby M, Sakr A, Sileri P, Wexner SD. Outcome of laparoscopic ventral mesh rectopexy for full-thickness external rectal prolapse: a systematic review, meta-analysis, and meta-regression analysis of the predictors for recurrence. Surg Endosc 2019; 33: 2444-55.
• Nacion AJD, Park YY, Kim HS, Yang SY, Kim NK. Surgical treatment of rectal prolapse: a 10-year experience at a single institution. J Minim Invasive Surg 2019; 22: 164-70
• Leventoglu S, Mentes B, Balci B, Yildiz A. Surgical techniques for rectal prolapse. Gastroenterol Insights 2021; 12: 310-8.
• Bordeianou L, Paquette I, Johnson E, et al. Clinical practice guidelines for the treatment of rectal prolapse. Dis Colon Rectum 2017; 60: 1121-31.
• Loh KC, Umanskiy K. Ventral Rectopexy. Clin Colon Rectal Surg 2021; 34: 62-8.
• Tsunoda A, Takahashi T, Matsuda S, Oka N, Kusanagi H. Midterm functional outcome after laparoscopic ventral rectopexy for external rectal prolapse. Asian J Endoscopic Surg 2020; 13: 25-32.
• Mäkelä-Kaikkonen J, Rautio T, Kairaluoma M, et al. Does ventral rectopexy improve pelvic floor function in the long term? Dis Colon Rectum 2018; 61: 230-8.
• Fu CW, Stevenson AR. Risk factors for recurrence after laparoscopic ventral rectopexy. Dis Colon Rectum 2017; 60: 178-86.
• Jorge JMN, Wexner SD. Etiology and management of fecal incontinence. Dis Colon Rectum 1993; 36: 77-97.
• Ahmad NZ, Stefan S, Adukia V, Naqvi SAH, Khan J. Laparoscopic ventral mesh rectopexy: functional outcomes after surgery. Surg J 2018; 4: e205-e11.
• Lundby L, Iversen LH, Buntzen S, Wara P, Høyer K, Laurberg S. Bowel function after laparoscopic posterior sutured rectopexy versus ventral mesh rectopexy for rectal prolapse: a double-blind, randomised single-centre study. Lancet Gastroenterol Hepatol 2016; 1: 291-7.
• Maggiori L, Bretagnol F, Ferron M, Panis Y. Laparoscopic ventral rectopexy: a prospective long-term evaluation of functional results and quality of life. Tech Coloproctol 2013; 17: 431-6.
• Tsunoda A. Surgical treatment of rectal prolapse in the laparoscopic era; a review of the literature. J Anus Rectum Colon 2020; 4: 89-99.
• Gleditsch D, Wexels WA, Nesbakken A. Surgical options and trends in treating rectal prolapse: long-term results in a 19-year follow-up study. Langenbeck’s Arch Surg 2018; 403: 991-8.
• Steele SR, Goetz LH, Minami S, Madoff RD, Mellgren AF, Parker SC. Management of recurrent rectal prolapse: surgical approach influences outcome. Dis Colon Rectum 2006; 49: 440-5.
• Tsunoda A, Takahashi T, Ohta T, Fujii W, Kusanagi H. New-onset rectoanal intussusception may not result in symptomatic improvement after laparoscopic ventral rectopexy for external rectal prolapse. Tech Coloproctol 2016; 20: 101-7.
• Madbouly KM, Youssef M. Laparoscopic ventral rectopexy versus laparoscopic wells rectopexy for complete rectal prolapse: long-term results. J Laparoendosc Adv Surg Tech 2018; 28: 1-6.
• Jonkers HF, Maya A, Draaisma W, Bemelman W, Broeders I, Consten E, et al. Laparoscopic resection rectopexy versus laparoscopic ventral rectopexy for complete rectal prolapse. Tech Coloproctol 2014; 18: 641-6.