Long-term outcome after laparoscopic and open surgery for rectal prolapse

Kariv, Yehuda; Delaney, Conor P.; Casillas, Sergio; Hammel, Jeffrey; Nocero, John; Bast, Jane; Brady, Karen; Fazio, Victor W.; Senagore, Anthony J.

doi:10.1007/s00464-005-3012-2

Cited by 104 publications

(33 citation statements)

References 47 publications

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“…3,22–24 There is no consensus on a single best method for rectal prolapse repair. 1,2,12 The cases presented in this series represent successful treatment of rectal prolapse with biologically derived graft reinforcement with UBM material, with satisfactory repairs and durability beyond 3 years.…”

Section: Discussionmentioning

confidence: 90%

“…2,4–11 Although several repair techniques are used today, laparoscopic rectopexy with either suture alone or graft reinforcement and with or without sigmoidectomy, is a commonly performed surgical repair technique. 2,12–14 Although there is no clear consensus, increasing concerns have been raised in the literature with respect to the complications of synthetic mesh repairs. 2,4–11 Rectal wall mesh erosion requiring major surgery has been reported in both posterior and anterior rectopexy with synthetic mesh.…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic Rectopexy with Urinary Bladder Xenograft Reinforcement

Mehta

Afshar

Warner

et al. 2017

JSLS

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Background and Objectives:Rectal prolapse is often repaired laparoscopically, frequently with the use of reinforcement material. Both synthetic and biologically derived materials reduce recurrence rate compared to primary suture repair. Synthetic mesh introduces potential complications such as mesh erosion, fibrosis, and infection. Urinary bladder matrix (UBM) represents a biologically derived material for reinforcement of rectal prolapse repair with the potential to improve durability without risks of synthetic materials. The objective of the study is to evaluate the effectiveness, durability, and functional result of laparoscopic rectopexy using urinary bladder matrix xenograft reinforcement at three years follow up.Methods:The 20 cases presented describe rectal prolapse repair by means of laparoscopic rectopexy with presacral UBM reinforcement. Patients were followed up for an average of 3 years and assessed with interviews, physical examination, manometry, and the fecal incontinence severity index (FISI).Results:Each repair was completed laparoscopically. UBM exhibited favorable handling characteristics when sutured to the sacrum and the lateral rectal walls. One patient underwent laparoscopic drainage of a postoperative abscess; no other complications occurred. In 3 years of follow-up, there have been no full-thickness recurrences, erosions, reoperations, or long-term complications. Two patients exhibited a small degree of mucosal prolapse on follow-up physical examination that did not require surgery. Three-year FISI scores averaged 8 (range, 0–33 of a possible 61), indicating low fecal incontinence symptomatology. Follow-up anorectal manometry was performed in 9 patients, showing mixed results.Conclusion:Surgeons may safely use laparoscopic rectopexy with UBM reinforcement for repair of rectal prolapses. In this series, repairs with UBM grafts have been durable at 3-year follow-up and may be an alternative to synthetic mesh reinforcement of rectal prolapse repairs. Future studies may compare the advantages and cost-effectiveness of reinforcement materials for rectal prolapse repair.

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Section: Discussionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Laparoscopic Rectopexy with Urinary Bladder Xenograft Reinforcement

Mehta

Afshar

Warner

et al. 2017

JSLS

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“…Laparoscopic repair9-11 seems as effective as open surgery and results in faster convalescence and less postoperative pain 12-15…”

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confidence: 99%

Robot-Assisted vs . Conventional Laparoscopic Rectopexy for Rectal Prolapse: A Comparative Study on Costs and Time

Heemskerk¹,

Hoog²,

Gemert³

et al. 2007

Diseases of the Colon &Amp; Rectum

133

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PurposeLaparoscopic rectopexy has become one of the most advocated treatments for full-thickness rectal prolapse, offering good functional results compared with open surgery and resulting in less postoperative pain and faster convalescence. However, laparoscopic rectopexy can be technically demanding. Once having mastered dexterity, with robotic assistance, laparoscopic rectopexy can be performed faster. Moreover, it shortens the learning curve in simple laparoscopic tasks. This may lead to faster and safer laparoscopic surgery. Robot-assisted rectopexy has been proven safe and feasible; however, until now, no study has been performed comparing costs and time consumption in conventional laparoscopic rectopexy vs. robot-assisted rectopexy.MethodsOur first 14 cases of robot-assisted laparoscopic rectopexy were reviewed and compared with 19 patients who underwent conventional laparoscopic rectopexy in the same period.ResultsRobot-assisted laparoscopic rectopexy did not show more complications. However, the average operating time was 39 minutes longer, and costs were -57.29 (or: $745.09) higher.ConclusionRobot-assisted laparoscopic rectopexy is a safe and feasible procedure but results in increased time and higher costs than conventional laparoscopy.

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“…With a single conversion within the group of elderly (overall rate of 0.6%, group of elderly 2.3%), a lower conversion rate was observed than that reported by others [5,24,25]. In a study with 111 patients, among which 32 patients received resection rectopexy, the overall conversion rate was 7.2% [25].…”

Section: Discussionmentioning

confidence: 60%

“…In a study with 111 patients, among which 32 patients received resection rectopexy, the overall conversion rate was 7.2% [25]. Neither the conversion rates for resection rectopexy nor for a subgroup of elderly patients were given.…”

Section: Discussionmentioning

confidence: 99%

Outcome analysis of elderly patients undergoing laparoscopic resection rectopexy for rectal prolapse

Laubert

Bader

Kleemann

et al. 2012

Int J Colorectal Dis

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This study supports the benefits of LRR for rectal prolapse in elderly patients. Age per se is not a contraindication for LRR. Elderly patients encounter complications slightly more frequently (although not statistically significant) than younger patients. Therefore, a very careful patient selection in the elderly is of paramount importance. However, the long-term outcome does not seem to differ between younger and elderly patients.

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Long-term outcome after laparoscopic and open surgery for rectal prolapse

Abstract: The hospital stay is shorter for LR than for OR. Both functional results and recurrent full-thickness rectal prolapse were similar for LR and OR during a mean follow-up period of 5 years.

Cited by 104 publications

References 47 publications

Laparoscopic Rectopexy with Urinary Bladder Xenograft Reinforcement

Laparoscopic Rectopexy with Urinary Bladder Xenograft Reinforcement

Robot-Assisted vs . Conventional Laparoscopic Rectopexy for Rectal Prolapse: A Comparative Study on Costs and Time

Outcome analysis of elderly patients undergoing laparoscopic resection rectopexy for rectal prolapse

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