Anterior rectopexy for full-thickness rectal prolapse: Technical and functional results

Abstract

Based on the low long-term recurrence rate and favorable outcome data in terms of low de novo constipation rate, improvement of anal incontinence, and low complications rate, laparoscopic anterior rectopexy seems to emerge as an efficient procedure for the treatment of patients with total rectal prolapse.

New kid on the block: perineal stapled prolapse resection (PSP) is it worthwhile in the long-term?

“…The recurrence rate after procedures with an abdominal approach seems to be lower [29] but to come at the cost of more and severer complications [30]. Perhaps, the latter becomes less pronounced as a consequence of wider usage of laparoscopy and D'Hoore's ventral rectopexy, as newer reviews propose [31,32]. Though, a reoperation rate of 4.8 % still seems rather high [32].…”

Laparoscopic ventral rectopexy is the gold standard treatment for rectal prolapse

“…The perineal approach is associated with a high recurrence rate and, as a result, is only advocated for patients who are not candidates for an abdominal operation [1]. It is nowadays generally accepted that the abdominal procedures carry a lower recurrence rate and improved functional outcome and they are therefore preferred to the perineal procedures [2].…”

“…Several procedures have been described to treat rectal prolapse [1]. The aims of the surgical treatment are to correct the anatomical abnormality and to cure the accompanying symptoms of incontinence, constipation and pain, with the lowest rate of complications as possible and an acceptable rate of recurrence.…”

“…Fourth, Douglas pouch removal was part of the original procedure and is probably one of the reasons why the recurrence rate is so low (around 3 % in the long term) [1]. The rationale for that is based on the fact that in patients suffering from rectal prolapse, one of the anatomical abnormalities is the deep Douglas pouch.…”

“…Most surgeons now perform the socalled D'Hoore operation, which is a ventral rectopexy and recognized as the gold standard [1].…”