Should we offer ventral rectopexy to patients with recurrent external rectal prolapse?

Gurland, Brooke; Carvalho, Maria Emilia Carvalho e; Ridgeway, Beri; Paraíso, Marie Fidela R.; Hull, Tracy L.; Zutshi, Massarat

doi:10.1007/s00384-017-2858-9

Cited by 16 publications

(18 citation statements)

References 24 publications

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“…Previous VMR induces adhesion formation to the pelvic area, and it could be expected that this hampers reoperations. In light of this, our study showed a reasonably low complication rate of 23.3%, which is in line with the results of Gurland et al [15], who reported a complication rate of 19.4%. Brunner et al [16] had a lower complication rate (13.3%) in their study.…”

Section: Discussionsupporting

confidence: 93%

“…Its effect on improving QoL, symptom changes for the better and less postoperative pelvic pain were more likely in patients with ERP than in IRP patients. There are only two previous publications reporting the results of LVMR or RVMR performed as revisional surgery [15,16]. They differ significantly from our study, since the primary operations in these studies varied, including perineal operations such as Altemeier and Delorme procedures.…”

Section: Discussioncontrasting

confidence: 77%

“…Brunner et al [16] had a lower complication rate (13.3%) in their study. It is noteworthy that almost all the patients in these previous series [15,16] were initially operated on using other techniques than LVMR. In the work of Brunner et al, the patients were primarily operated on using a perineal approach, and thus the anatomical planes in the abdomen and pelvis were untouched.…”

Section: Discussionmentioning

confidence: 99%

“…However, they could not comment on other aspects of redo surgery in their consensus report, since there was, and still is, an urgent need for guidance on clinical decision-making after unsuccessful LVMR. There are only two small studies that report the results of LVMR or RVMR after a primary ERP operation using a variety of surgical techniques [15,16].…”

Section: Introductionmentioning

confidence: 99%

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Redo ventral rectopexy: is it worthwhile?

et al. 2020

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Background Minimally invasive ventral mesh rectopexy (VMR) is a widely used surgical treatment for posterior pelvic organ prolapse; however, evidence of the utility of revisional surgery is lacking. Our aim was to assess the technical details, safety and outcomes of redo minimally invasive VMR for patients with external rectal prolapse (ERP) recurrence or relapsed symptoms of internal rectal prolapse (IRP). Methods This is a retrospective cohort study of patients with recurrent ERP or symptomatic IRP who underwent redo minimally invasive VMR between 2011 and 2016. The study was conducted at three hospitals in Finland. Data collected retrospectively included patient demographics, in addition to perioperative and short-term postoperative findings. At follow-up, all living patients were sent a questionnaire concerning postoperative disease-related symptoms and quality of life. Results A total of 43 redo minimally invasive VMR were performed during the study period. The indication for reoperation was recurrent ERP in 22 patients and relapsed symptoms of IRP in 21 patients. In most operations (62.8%), the previously used mesh was left in situ and a new one was placed. Ten (23.3%) patients experienced complications, including 2 (4.7%) mesh-related complications. The recurrence rate was 4.5% for ERP. Three patients out of 43 were reoperated on for various reasons. One patient required postoperative laparoscopic hematoma evacuation. Patients operated on for recurrent ERP seemed to benefit more from the reoperation. Conclusions Minimally invasive redo VMR appears to be a safe and effective procedure for treating posterior pelvic floor dysfunction with acceptable recurrence and reoperation rates.

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Section: Discussionsupporting

confidence: 93%

Section: Discussioncontrasting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Redo ventral rectopexy: is it worthwhile?

et al. 2020

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“…This was studied in a prospective cohort study looking at 108 patients who underwent VR. 17 Prolapse recurrence rates were reported at 1.4, 6.9, and 9.7% for primary repairs and at 13.9, 25, and 25% for recurrent prolapse procedures at 1, 3, and 5 years, respectively. Time to recurrence was much shorter for those undergoing VR for recurrent prolapse.…”

mentioning

confidence: 91%

Ventral Rectopexy

Loh

Umanskiy

2020

Clin Colon Rectal Surg

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Rectal prolapse is a debilitating condition that often results in impaired quality of life. Posterior compartment defects including rectal prolapse and rectal intussusception are often associated with middle and anterior compartment prolapse and require a multicompartment approach to treatment. In recent years, ventral rectopexy, with or without sacrocolpopexy for combined middle compartment prolapse, has emerged as a safe and effective method of treatment for rectal prolapse. In this article, we aim to review the etiology of rectal prolapse and intussusception, describe the indications and workup for surgery, discuss technical aspects of ventral rectopexy alone and in combination with sacrocolpopexy, review potential surgical complications, and describe the reported outcomes of the surgery.

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