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, 13 (1), 25-32

Midterm Functional Outcome After Laparoscopic Ventral Rectopexy for External Rectal Prolapse

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Midterm Functional Outcome After Laparoscopic Ventral Rectopexy for External Rectal Prolapse

Akira Tsunoda et al. Asian J Endosc Surg.

Abstract

Introduction: Although long-term crude outcomes of laparoscopic ventral rectopexy for external rectal prolapse (ERP) have been documented, repetitive functional and quality of life (QOL) assessments are scarce. This study assessed midterm annual functional results and QOL after laparoscopic ventral rectopexy for ERP.

Methods: This study consisted of 58 patients and was a retrospective analysis of prospectively collected data. The Fecal Incontinence Severity Index, the Constipation Scoring System, and QOL instruments (ie 36-item Short-Form Health Survey and Fecal Incontinence Quality of Life scale) were administered before and after operation.

Results: There was no mortality or major morbidity. After a median follow-up of 49 months (6-92 months), recurrence of ERP was noted in one patient (2%). There were no mesh-related complications. The median Fecal Incontinence Severity Index score was significantly reduced at 3 months (34 [10-61] vs 12 [0-50], P < 0.0001) and remained significantly reduced for 5 years. The median Constipation Scoring System score was significantly reduced at 3 months (14 [9-20] vs 7 [0-16], P < 0.0001) and remained significantly reduced for 4 years. No patients developed new-onset constipation. All of the Fecal Incontinence Quality of Life scales significantly improved overtime for 4 years. All of the 36-item Short-Form Health Survey scales were significantly improved at 3 and 6 months, but none of the scales significantly improved after 2 years.

Conclusion: Laparoscopic ventral rectopexy for ERP was associated with low morbidity, low recurrence, and a midterm improvement in function and fecal incontinence-specific QOL.

Keywords: external rectal prolapse; laparoscopic ventral rectopexy; midterm results.

Figures

Figure 1
Figure 1
Scores from the 36‐item Short Form Health Survey in patients with external rectal prolapse and rectoanal intussusception. The boxes show median values with upper and lower quartiles. The vertical lines extend from the minimum to the maximum values. Abbreviations: n, number of patients who responded to each questionnaire. Preoperative scores were compared with postoperative scores by using the Wilcoxon signed‐rank test. *P < 0.05. **P < 0.01. ***P < 0.0001
Figure 2
Figure 2
Fecal Incontinence Quality of Life scores in patients with external rectal prolapse and rectoanal intussusception. The boxes show median values with upper and lower quartiles. The vertical lines extend from the minimum to the maximum values. Abbreviations: n, number of patients who responded to each questionnaire. Preoperative scores were compared with postoperative scores by using the Wilcoxon signed‐rank test. *P < 0.0001. ** P < 0.01. ***P < 0.05

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