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Laparoscopic resection rectopexy for rectal prolapse: a single-center study during 16 years.
- Source :
- Surgical Endoscopy & Other Interventional Techniques; Oct2010, Vol. 24 Issue 10, p2401-2406, 6p, 3 Charts
- Publication Year :
- 2010
-
Abstract
- Background: Many different techniques to treat rectal prolapse have been introduced. Laparoscopic resection rectopexy has been shown to entail benefits regarding both perioperative results and short-term outcome, whereas data for long-term outcome are scarce. Methods: Between 1993 and 2008, all laparoscopic resection rectopexies for rectal prolapse II° or III° were selected from a prospective laparoscopic colorectal surgery database. We analyzed demographic, perioperative, and follow-up results. We defined two periods (1993-2000 and 2001-2008) for comparison of data. Long-term follow-up was obtained by sending questionnaires to all patients. Evaluation included constipation, incontinence, and recurrence of prolapse. Results: Between January 1993 and November 2008, we performed 152 laparoscopic resection rectopexies for rectal prolapse. Median age was 64.1 years (±14.6). Conversion rate was 0.7% (1), mean operation time was 204 (±65.3) min, and was significantly shorter in the second period compared with the first ( P < 0.0001). Mortality was 0.7% ( n = 1). Complication rates were 4% ( n = 6; major) and 19.2% ( n = 29; minor), respectively. Mean length of hospital stay was 11.3 (±6.4) days and was significantly shorter in the second period compared with the first period ( P < 0.0001). Mean time of follow-up was 47.7 (±41.6) months. Improvement or complete elimination of constipation was stated by 81.3% (65), and improvement or elimination of incontinence was stated by 67.3% (72). Overall recurrence rate was 11.1% ( n = 10) with a rate of 5.6% ( n = 5) for a 5-year period. Of those patients with previous perineal surgery for rectal prolapse, 53.8% (7/13) experienced recurrent prolapse after laparoscopic resection rectopexy in contrast to 3.9% (3/77) of patients without previous perineal prolapse surgery ( P < 0.0001). Conclusions: Our data support the benefits of laparoscopic resection rectopexy for rectal prolapse regarding both perioperative results and long-term functional outcome. Preceding perineal or open abdominal operations have an impact on recurrence after laparoscopic resection rectopexy. [ABSTRACT FROM AUTHOR]
- Subjects :
- LAPAROSCOPIC surgery
RECTAL prolapse
SURGICAL excision
MORTALITY
PATIENTS
Subjects
Details
- Language :
- English
- ISSN :
- 18666817
- Volume :
- 24
- Issue :
- 10
- Database :
- Complementary Index
- Journal :
- Surgical Endoscopy & Other Interventional Techniques
- Publication Type :
- Academic Journal
- Accession number :
- 53913168
- Full Text :
- https://doi.org/10.1007/s00464-010-0962-9