Laparoscopic Suture versus Mesh Rectopexy for the Treatment of Persistent Complete Rectal Prolapse in Children: A Comparative Randomized Study

Yehya, Abdelaziz; Gamaan, Ibrahim; Abdelrazek, Mohamed; Shahin, Mohamed; Seddek, Ashraf; Abdelhafez, Mohamed

doi:10.1155/2020/3057528

Cited by 7 publications

(12 citation statements)

References 25 publications

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“…3,4,5 Perineal descent syndrome (PDS) and Rectal prolapse is typically a self-limited problem in children without underlying conditions so its evaluation and treatment are initially conservative . 6,7,8,9 Constipation occurred in our sample in 20 cases (66.6 %); in comparison to 9 of 19 cases (47 %). 7 Fecal incontinence was present in 10 cases (33.3%), a low ratio compared to 5 of 8 cases (62.5%).…”

Section: Discussionmentioning

confidence: 50%

“…The basic objectives of surgical management of perineal descent syndrome and full rectal prolapse thickness is used to restore anatomy and physiology by controlling the external prolapse of the rectum; boost continence, boost bowel function (prevent constipation or evacuation impairment), and minimize the rate of recurrence with lower morbidity and death. 9,11,12 The growing body of literature reinforces the idea that laparoscopic surgical procedures can offer the benefits of low recurrence rates safely, improved clinical outcome, fewer postoperative pain, shorter hospital stay, and early bowel function return in patients with perineal descent syndrome. 2,12 Both laparoscopic rectopexy resection and laparoscopic rectopexy suture were defined with no resection; each having its own merits.…”

Section: Discussionmentioning

confidence: 95%

“…14 Laparoscopic complete posterior rectal mobilization and fastening to the sacrum alone has a high success rate, lower morbidity and mortality and lower sepsis and recurrence risk. 2,9 In all cases of the study (except laparoscopic anterior suture rectopexy cases) unilateral right-side pararectal dissect was performed and none of them were bilaterally dissected to prevent exposure of both external iliac vessels and ureters to the possibility of injury during the operation. This is contrary with bilateral pararectal dissection.…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic Management of Perineal Descent Syndrome in Pediatric Age Group

Ali

Ismail

Mostafa

et al. 2020

Al-Azhar International Medical Journal

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Background: Perineal descent syndrome is a disease that affects the pelvic floor because of denervation of its muscles, resulting in obstructed defecation. Hints on the anatomy that may be associated with the work got, and the physiology of the anorectum was explained, discussing factors leading to continence and mechanism of defecation was presented. Aim of work: to diagnose the perineal descent syndrome in both cases of chronic constipation and anal incontinence and usage of laparoscopy to treat PDS in children where the pathophysiological changes are known for each case and dealt with laparoscopically. Patient and Methods: This research was a forward-looking case study conducted during the period from June 2019 to June 2020 in the department of Pediatric Surgery, Al-Azhar university hospitals after approval by the Al Azhar Faculty of Medicine Ethical Review Committee. The research included 30 patients presented to the outpatient clinics with constipation or Fecal incontinence whom fulfilled the required Criteria. Results: In our study (n=30), 2 recurrent cases (13.3%) were found after laparoscopic suture rectopexy. Recurrence rates with mesh rectopexy or resection rectopexy was zero % and chronic constipation and fecal incontinence are considered as a hidden cause for perineal descent syndrome. Conclusion: The anterior rectal wall has a great dynamic role in defecation thanks to its viscoelastic properties. Any rectopexy technique should never interfere or impede this vital mechanism of action. Finally chronic constipation and fecal incontinence are considered as a hidden cause for perineal descent syndrome.

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Section: Discussionmentioning

confidence: 50%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

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Laparoscopic Management of Perineal Descent Syndrome in Pediatric Age Group

Ali

Ismail

Mostafa

et al. 2020

Al-Azhar International Medical Journal

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“…In contrast, ABD-ELFATTAH et al, 2022. showed a significant positive result regarding the improvement of continence postoperatively after laparoscopic Resection rectopexy, poste-rior and ventral laparoscopic Mesh rectopexy, meaning that there was a significant improvement of continence after LRR, posterior and ventral LMR (18) . Another study reported that fecal incontinence improved in 92.8% in laparoscopic resection rectopexy without mesh while in mesh rectopexy it was improved in 100% of cases (21) .…”

Section: Discussionmentioning

confidence: 97%

Posterior Mesh Rectopexy versus Resection Rectopexy in Complete Rectal Prolapse.

AlBade&#;a

Mahran²,

Abdelaziz³

et al. 2023

Minia Journal of Medical Research

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Background: Rectal procidentia (rectal prolapse) is a disabling condition. Surgical repair is the treatment of choice for candidates who have a full thickness rectal procidentia. Multiple procedures exist for the repair of rectal procidentia, however; none of them is most effective. Methods: This study was carried out at Minia University Hospital as a prospective non randomized study that compared laparoscopic posterior mesh rectopexy (Group A; n = 20) with Recto-sigmoidectomy (Group B; n = 20) for complete rectal prolapse as regards complications; functional outcomes (constipation and continence) and sexual functions after surgery. Results: The female to male ratio was 3: 2 and their ages ranged from 19-70 years with mean of 41.2 years. The operative time in the resection rectopexy group was significantly longer than the rectopexy group. No significant difference between the two groups regarding intraoperative complications (bleeding only). Resection rectopexy group had statistically significant drop in the constipation score than Posterior mesh rectopexy group with a mean score of 16.9 point(pre) and 2.3point(post) versus a score of 10.3point(pre) and 4.3point(post) respectively. There is no incontinence occurred in mesh rectopexy group but in resection rectopexy group; there were 6 patients developed incontinence with a range 0-20 point and mean 5.4 point The P-Value was 0.007 and it is statistically significant. Sexual functions are preserved in both groups. Conclusion: Although recto-sigmoidectomy seems to affect the continence, it improves constipation scores more significantly in patients with chronic constipation than the posterior mesh rectopexy. Sexual functions will be preserved in both operations.

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“…Studies by Sahoo et al [38], Usman et al [39], Yehya et al [40], and Bhandarwar et al [41] Operative Time (Minutes)…”

Section: Figure 3: Constipation Improvementmentioning

confidence: 99%

Outcomes of Laparoscopic Suture Rectopexy Versus Laparoscopic Mesh Rectopexy: A Systematic Review and Meta-Analysis

Kumari,

MadhuBabu,

Vaidya

et al. 2024

Cureus

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The contemporary literature provides conflicting evidence regarding the precedence of laparoscopic mesh rectopexy over laparoscopic suture rectopexy for full-thickness rectal prolapse. This study aimed to compare the clinical outcomes of mesh and suture rectopexy to improve the surgical management of complete rectal prolapse. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed to extract studies based on mesh versus suture rectopexy and published from 2001 to 2023. The articles of interest were obtained from PubMed Central, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Journal Storage (JSTOR), Web of Science, Embase, Scopus, and the Cochrane Library. The primary outcomes included rectal prolapse recurrence, constipation improvement, and operative time. The secondary endpoints included the Cleveland Clinic Constipation Score, Cleveland Clinic Incontinence Score, intraoperative bleeding, hospital stay duration, mortality, overall postoperative complications, and surgical site infection. A statistically significant low recurrence of rectal prolapse (odds ratio: 0.41, 95% confidence interval (CI) 0.21-0.80; p=0.009) and longer mean operative duration (mean difference: 27.05, 95% CI 18.86-35.24; p<0.00001) were observed in patients with mesh rectopexy versus suture rectopexy. Both study groups, however, had no significant differences in constipation improvement and all secondary endpoints (all p>0.05). The laparoscopic mesh rectopexy was associated with a low postoperative rectal prolapse recurrence and a longer operative duration compared to laparoscopic suture rectopexy. Prospective randomized controlled trials should further evaluate mesh and suture rectopexy approaches for postoperative outcomes to inform the surgical management of complete rectal prolapse.

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Laparoscopic Suture versus Mesh Rectopexy for the Treatment of Persistent Complete Rectal Prolapse in Children: A Comparative Randomized Study

Cited by 7 publications

References 25 publications

Laparoscopic Management of Perineal Descent Syndrome in Pediatric Age Group

Laparoscopic Management of Perineal Descent Syndrome in Pediatric Age Group

Posterior Mesh Rectopexy versus Resection Rectopexy in Complete Rectal Prolapse.

Outcomes of Laparoscopic Suture Rectopexy Versus Laparoscopic Mesh Rectopexy: A Systematic Review and Meta-Analysis

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