Long-term Outcome After Laparoscopic Ventral Mesh Rectopexy

Consten, Esther C. J.; Iersel, Jan J. van; Verheijen, Paul M.; Broeders, I. A. M. J.; Wolthuis, Albert; D’Hoore, André

doi:10.1097/sla.0000000000001401

Cited by 171 publications

(73 citation statements)

References 40 publications

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“…Thirty-eight of those 46 studies were excluded due surgery other than ventral rectopexy having been performed, postoperative complications not having been reported, or mesh-related erosion having not been observed among the complications; thus, eight studies were deemed eligible for inclusion (Fig. 1) [1213141516171819]. All studies reported synthetic mesh-related erosion [1213141516171819], and 1 study [19] reported both synthetic and biological mesh-related erosion (Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…1) [1213141516171819]. All studies reported synthetic mesh-related erosion [1213141516171819], and 1 study [19] reported both synthetic and biological mesh-related erosion (Table 1). Six studies were prospective, none of which was a randomized clinical trial [121314151619], 1 study was retrospective [17], and 1 study was a case report (Table 1) [18].…”

Section: Resultsmentioning

confidence: 99%

“…Polypropylene mesh was used in 2,085 cases, polyester in 850 cases, titanium-coated polypropylene in 160 cases, porcine dermal collagen in 309 cases, and porcine small-intestinal submucosa in 130 cases [12131415161719]. In 1 study, the synthetic mesh type was not specified [18], and in the study of Consten et al [17], 421 patients underwent LVR with placement of a prolene or a polyester mesh, but the exact number for each mesh type was not specified (Table 2).…”

Section: Resultsmentioning

confidence: 99%

“…In 1 study, the synthetic mesh type was not specified [18], and in the study of Consten et al [17], 421 patients underwent LVR with placement of a prolene or a polyester mesh, but the exact number for each mesh type was not specified (Table 2). Of the 3,956 patients, 1,041 (26.2%) experienced postoperative complications, 67 (1.7%) of which were mesh-related erosion.…”

Section: Resultsmentioning

confidence: 99%

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Synthetic Versus Biological Mesh-Related Erosion After Laparoscopic Ventral Mesh Rectopexy: A Systematic Review

et al. 2017

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PurposeThis review reports the incidence of mesh-related erosion after ventral mesh rectopexy to determine whether any difference exists in the erosion rate between synthetic and biological mesh.MethodsA systematic search of the MEDLINE and the Ovid databases was conducted to identify suitable articles published between 2004 and 2015. The search strategy capture terms were laparoscopic ventral mesh rectopexy, laparoscopic anterior rectopexy, robotic ventral rectopexy, and robotic anterior rectopexy.ResultsEight studies (3,956 patients) were included in this review. Of those patients, 3,517 patients underwent laparoscopic ventral rectopexy (LVR) using synthetic mesh and 439 using biological mesh. Sixty-six erosions were observed with synthetic mesh (26 rectal, 32 vaginal, 8 recto-vaginal fistulae) and one (perineal erosion) with biological mesh. The synthetic and the biological mesh-related erosion rates were 1.87% and 0.22%, respectively. The time between rectopexy and diagnosis of mesh erosion ranged from 1.7 to 124 months. No mesh-related mortalities were reported.ConclusionThe incidence of mesh-related erosion after LVR is low and is more common after the placement of synthetic mesh. The use of biological mesh for LVR seems to be a safer option; however, large, multicenter, randomized, control trials with long follow-ups are required if a definitive answer is to be obtained.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Synthetic Versus Biological Mesh-Related Erosion After Laparoscopic Ventral Mesh Rectopexy: A Systematic Review

et al. 2017

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“…Therefore, the primary objective of this study was to test the hypothesis that RPR rates are higher in women with clinically significant POP relative to women without POP. Given the notion that RPR might be greater after perineal vs abdominal repairs, as suggested by existing literature, 2,16–20 we also aimed to assess the combined effect of POP and surgical route on outcomes of RP repair.…”

mentioning

confidence: 99%

Recurrence of Rectal Prolapse After Surgical Repair in Women With Pelvic Organ Prolapse

Catanzarite

Klaristenfeld

Tomassi

et al. 2018

Diseases of the Colon &Amp; Rectum

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BACKGROUND Pelvic organ prolapse is prevalent among women with rectal prolapse. OBJECTIVE This study aimed to determine whether clinically significant pelvic organ prolapse impacts rectal prolapse recurrence after surgical repair. DESIGN A retrospective cohort. SETTING This study was performed at a single managed-care institution. PATIENTS Consecutive women undergoing rectal prolapse repair between 2008 and 2016 were included. INTERVENTIONS There were no interventions. MAIN OUTCOME MEASURES Full-thickness rectal prolapse recurrence was compared between 4 groups: abdominal repair without pelvic organ prolapse (AR−POP); abdominal repair with pelvic organ prolapse (AR+POP); perineal repair without pelvic organ prolapse PR−POP; and perineal repair with pelvic organ prolapse (PR+POP). Recurrence-free period and hazard of recurrence were compared using Kaplan-Meier and Cox proportional hazards methods. To identify potential confounding risk factors for rectal prolapse recurrence, the characteristics of subjects with/without recurrence were compared with univariable and multivariable analyses. RESULTS Overall, pelvic organ prolapse was present in 33% of 112 women and was more prevalent among subjects with rectal prolapse recurrence (52.4% vs 28.6%, p = 0.04). Median follow-up was 42.5 months; rectal prolapse recurrence occurred in 18.8% at a median of 9 months. The rate of recurrence and the recurrence-free period differed significantly between groups: AR−POP 3.8%, 95.7 months; AR+POP 13.0%, 86.9 months; PR−POP 34.8%, 42.1 months; PR+POP 57.1%, 23.7 months (p < 0.001). Compared with AR−POP the HR (95% CI) of rectal prolapse recurrence was 3.1 (0.5–18.5) for AR+POP; 14.7 (3.0–72.9) for PR−POP and 31.1 (6.2–154.5) for PR+POP. Compared with AR+POP, PR+POP had a shorter recurrence-free period (p < 0.001) and a higher hazard of recurrence (HR, 10.2; 95% CI, 2.1–49.3). LIMITATIONS The retrospective design was a limitation of this study. CONCLUSIONS Pelvic organ prolapse was associated with a higher rectal prolapse recurrence rate and earlier recurrence in women undergoing perineal, but not abdominal, repairs. Multidisciplinary evaluation can facilitate individualized management of women with rectal prolapse. Abdominal repair should be considered in women with concomitant rectal and pelvic organ prolapse. See Video Abstract, at http://links.lww.com/DCR/A513.

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The use of polymeric meshes for pelvic organ prolapse: Current concepts, challenges, and future perspectives

et al. 2019

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Pelvic organ prolapse (POP) is one of the most common chronic disorders in women, impacting the quality of life of millions of them worldwide. More than 100 surgical procedures have been developed over the decades to treat POP. However, the failure of conservative strategies and the number of patients with recurrence risk have increased the need for further adjuvant treatments. Since their introduction, surgical synthetic meshes have dramatically transformed POP repair showing superior anatomic outcomes in comparison to traditional approaches. Although significant progress has been attained, among the meshes in clinical use, there is no single mesh appropriate for every surgery. Furthermore, due to the risk of complications including acute and chronic infection, mesh shrinkage, and erosion of the tissue, the benefits of the use of meshes have recently been questioned. The aim of this work is to review the evolution of POP surgery, analyzing the current challenges, and detailing the key factors pertinent to the design of new mesh systems. Starting with a description of the pelvic floor anatomy, the article then presents the traditional treatments used in pelvic organ disorders. Next, the development of synthetic meshes is described with an insight into how their function is dependent on both mesh design variables (i.e., material, structure, and functional treatment) and surgical applications. These are then linked to common mesh‐related complications, and an indication of current research aiming to address these issues.

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Long-term Outcome After Laparoscopic Ventral Mesh Rectopexy

Abstract: LVR is safe and effective for the treatment of different rectal prolapse syndromes. Long-term recurrence rates are in line with classic types of mesh rectopexy and occurrence of mesh-related complications is rare.

Cited by 171 publications

References 40 publications

Synthetic Versus Biological Mesh-Related Erosion After Laparoscopic Ventral Mesh Rectopexy: A Systematic Review

Synthetic Versus Biological Mesh-Related Erosion After Laparoscopic Ventral Mesh Rectopexy: A Systematic Review

Recurrence of Rectal Prolapse After Surgical Repair in Women With Pelvic Organ Prolapse

The use of polymeric meshes for pelvic organ prolapse: Current concepts, challenges, and future perspectives

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