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, 34 (3), 119-124

Laparoscopic Posterolateral Rectopexy for the Treatment of Patients With a Full Thickness Rectal Prolapse: Experience With 63 Patients and Short-term Outcomes

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Laparoscopic Posterolateral Rectopexy for the Treatment of Patients With a Full Thickness Rectal Prolapse: Experience With 63 Patients and Short-term Outcomes

Keehoon Hyun et al. Ann Coloproctol.

Abstract

Purpose: Although numerous procedures have been proposed for the treatment of patients with a rectal prolapse, the most effective operation has not yet been established. Minimal rectal mobilization can prevent constipation; however, it is associated with increased recurrence rates. We describe our novel method for a laparoscopic posterolateral rectopexy, which includes rectal mobilization with a posterior-right unilateral dissection, suture fixation to the sacral promontory with a polypropylene mesh (Optilene), and a mesorectal fascia propria that is as wide as possible. The present report describes our novel method and assesses the short-term outcomes of patients.

Methods: Between June 2014 and June 2017, 63 patients (28 males and 35 females) with a full-thickness rectal prolapse underwent a laparoscopic posterolateral (LPL) rectopexy. We retrospectively analyzed the clinical characteristics and postoperative complications in those patients. The outcome of surgery was determined by evaluating the answers on fecal incontinence questionnaires, the results of anal manometry preoperatively and 3 months postoperatively, the patients' satisfaction scores (0-10), and the occurrence of constipation.

Results: No recurrence was reported during follow-up (3.26 months), and 3 patients reported postoperative complications (wound infection, postoperative sepsis, which was successfully treated with conservative management, and retrograde ejaculation). Compared to the preoperative baseline, fecal incontinence at three months postoperatively showed an overall improvement. The mean patient satisfaction score was 9.55 ± 0.10, and 8 patients complained of persistent constipation.

Conclusion: LPL rectopexy is a safe, effective method showing good functional outcomes by providing firm, solid fixation for patients with a full-thickness rectal prolapse.

Keywords: Constipation; Posterior mesh rectopexy; Rectal prolapse.

Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.
(A) Posterior fixation. The mesh is fixed to the periosteum of the sacral promontory, and the rectal fascia propria is sutured as wide as possible. (B) Lateral fixation. The peritoneum and the right mesorectal fascia propria are sutured by using continuous interlocking sutures with mesh. (C) The anterior peritoneum remains open for use as a drainage window.
Fig. 2.
Fig. 2.
Box plots of the Wexner score (A), fecal incontinence quality of life (FIQOL) score (B), and fecal incontinence severity index (FISI) score (C).

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References

    1. Bordeianou L, Hicks CW, Kaiser AM, Alavi K, Sudan R, Wise PE. Rectal prolapse: an overview of clinical features, diagnosis, and patient-specific management strategies. J Gastrointest Surg. 2014;18:1059–69. - PubMed
    1. Yoon SG. Rectal prolapse: review according to the personal experience. J Korean Soc Coloproctol. 2011;27:107–13. - PMC - PubMed
    1. D’Hoore A, Cadoni R, Penninckx F. Long-term outcome of laparoscopic ventral rectopexy for total rectal prolapse. Br J Surg. 2004;91:1500–5. - PubMed
    1. Formijne Jonkers HA, Poierrie N, Draaisma WA, Broeders IA, Consten EC. Laparoscopic ventral rectopexy for rectal prolapse and symptomatic rectocele: an analysis of 245 consecutive patients. Colorectal Dis. 2013;15:695–9. - PubMed
    1. Mercer-Jones MA, D’Hoore A, Dixon AR, Lehur P, Lindsey I, Mellgren A, et al. Consensus on ventral rectopexy: report of a panel of experts. Colorectal Dis. 2014;16:82–8. - PubMed
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