Ventral colporectopexy for overt rectal prolapse and obstructed defaecation syndrome: a systematic review

Gouvas, Nikolaos; Georgiou, Panagiotis; Agalianos, Christos; Tan, Ek Khoon; Tekkis, Paris; Dervenis, Christos; Xynos, Evaghelos

doi:10.1111/codi.12751

Cited by 50 publications

(31 citation statements)

References 60 publications

(372 reference statements)

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“…The LVMR is gaining acceptance as a treatment method for both the external and internal rectal prolapse and complex rectocele with associated ODS and/or faecal incontinence [7,9]. In the long run, approximately 80 % of patients with ODS and intussusception would benefit from LVMR [5].…”

Section: Discussionmentioning

confidence: 99%

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Anatomical and functional changes to the pelvic floor after robotic versus laparoscopic ventral rectopexy: a randomised study

et al. 2016

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Section: Discussionmentioning

confidence: 99%

“…It is mainly indicated to treat rectal prolapse [5,6], but lately it has also been offered to selected patients with internal rectal prolapse and complex rectocele, and has shown improved functional results [7][8][9][10][11]. LVMR provides an option to correct middle and posterior compartment procidentia at the same time.…”

Section: Introductionmentioning

confidence: 99%

Anatomical and functional changes to the pelvic floor after robotic versus laparoscopic ventral rectopexy: a randomised study

et al. 2016

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“…Laparoscopic ventral mesh rectopexy is now considered safe and effective and results of large case series from tertiary centres [3][4][5] and systematic reviews [6,7] support this view. To our knowledge so far results of LVMR from a district general hospital in the UK has not been published.…”

Section: Discussionmentioning

confidence: 96%

Safety and Efficacy of Laparoscopic Ventral Mesh Rectopexy and Sacrocolpopexy for Rectal Prolapse and Obstructed Defecation: Analysis of First 20 Cases at a UK District General Hospital

Tennakoon¹,

Farook²

2016

Surgery

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Journal of Surgery IntroductionLaparoscopic ventral mesh rectopexy (LVMR) is gaining wider acceptance amongst colorectal surgeons as the technique that can address symptoms of both external and internal rectal prolapse. It also allows correction of any associated rectocele, enterocele and posterior vaginal wall prolapse as well as vault prolapse. The learning curve for LVMR is unknown and there is no consensus on case selection. The aim of this study is to share our results to show that LVMR can be learnt and safely performed by experienced laparoscopic colorectal surgeons in district general hospitals with short term results similar to that of establish centres. MethodologyPrior to start of this retrospective study UK National Health Service Health Research Authority website was consulted and NHS Research Ethics Committee approval was not required. The procedures followed were in accordance with the principles of the Helsinki Declaration of 1975, as revised in 2000.Laparoscopic Ventral Mesh Rectopexy was started at our institution in January 2011. All patients presented with obstructed defecation syndrome (ODS) and rectal prolapse from January 2011 to January 2015 are included in this analysis. Patients presenting to the out patients department with symptoms of difficulty in evacuation, sense of incomplete evacuation, pelleted stools, frequent visits to the toilet, perineal, vaginal or anal digitation, incontinence and pelvic pain were clinically diagnosed as having obstructed defecation. All with such symptoms were investigated with anorectal physiology, defecation proctography, colon transit studies, colonoscopy or sigmoidoscopy as appropriate. Patients with obvious rectal prolapse underwent either colonoscopy or sigmoidoscopy as indicated.Fluoroscopic defecography was performed with vaginal, oral and bladder contrast. Defecography, anorectal physiology and symptoms were discussed in the fortnightly pelvic floor MDT which consists of two colorectal surgeons (both authors), one radiologist, the radiographer who performs defecography, one urogynaecologist and the colorectal nurse specialist who performs anorectal physiology and biofeedback. Fluoroscopy films were reviewed by all MDT members and intussusception was graded according to oxford prolapse grade [1] (Grade 1-High recto rectal intussusception, Grade 2-Low recto-rectal intussusception, Grade 3-High recto-anal intussusception, Grade 4-Low recto-anal intussusception, Grade 5-Complete rectal prolapse). Evacuation time, number of attempts at evacuation and speed of opening of the anal canal were considered as subjective global markers of evacuation efficiency. In the case of rectocele barium trapping in the rectocele was considered significant. All patients with ODS then underwent maximal medical therapy as well as biofeedback. Since 2012 patients are offered trans anal irrigation as a form of conservative treatment if they do not respond to maximal medical therapy. Patients with high grade intussusception (Grade 3 and 4) and reduced AbstractIntroduction: ...

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“…Recurrance rates ranges from 0 to 14%. At the last year in our centre this procedure is the main option for rectal prolapse treatment [10,11].…”

Section: Discussionmentioning

confidence: 99%

Tiesiosios žarnos iškritimo chirurginis gydymas – vieno centro patirtis

Danys¹,

Kavaliauskaitė²,

Žalimas³

et al. 2016

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BackgroundNo consensus on the optimal procedure for repair of rectal prolapse (RP) exist. We present the results of our 10 year experience of Vilnius University Hospital Santariskiu Klinikos. Patients and methodsRetrospective review was performed of the patients, operated on for rectal prolapse between 2005 and 2016. Patients were divided into two groups -internal recal prolapse (IRP) and complete rectal prolapse (CRP). Perioperative data between two groups were analysed. Statistical data analysis was carried out using the SPSS 20.0 software. To assess the difference between rectal prolapse groups of statistical methods the χ 2 test was used. Data were considered statistically significant at p < 0.05. Results 89 patients between 2005 and 2016 underwent surgical treatment for rectal prolapse at our department. IRP group included 52 (58,4%), CRP -37 (41,6%) patients. The male/female ratio was 1/6,4, the mean age was 58,3±15,2 years. Defecography was performed for 29 (32,6%)patients in IRP group and for 12 (13,5%) -in CRP group (p<0,001). 7 (7,9%) patients in CRP group had previous surgical procedure for RP while in IRP group there were none (p=0,02). The most common management of IRP included 6 strategies (n=25, 67,5% of group); of CRP -3 different procedures (n=38, 73,1% of group) (p=0,003). Mean hospital stay in IRP group was significantly (p=0,014) longer (9,78±4,6 days) than in CRP group (7,58±3,7 days). Mortality rate was 0 %. Mean follow-up (14 patients) was 20,93±17,21 months. ConclusionThere is no evidence-based consensus regarding treatment of rectal prolapse. Management of IRP covered a more diverse range of surgical options, including of open approach. Thus, hospital stay was longer, but no mortality occurred. Further follow-up for evaluation of long-term outcome is necessary. Key words: rectal prolapse, rectopexy, resection, laparoscopy 153Surgery for rectal prolapse -a single centre experience Įvadas Dėl vienos tiesiosios žarnos iškritimo gydymo strategijos nesutariama. Mes apžvelgėme tiesiosios žarnos iškritimo gydymą Vilniaus universiteto ligoninėje Santariškių klinikose. Pacientai ir metodaiRetrospektyviai tirti pacientai, operuoti dėl tiesiosios žarnos iškritimo 2005-2016 metais. Pacientai suskirstyti į dvi grupesviso storio iškritimo (CRP) ir vidinio iškritimo (IRP). Buvo palyginti perioperaciniai grupių duomenys. Duomenys apdoroti statistinio duomenų paketo SPSS 20.0 versija. Skirtumas tarp grupių lygintas remiantis chi kvadrato testu, vertintas kaip reikš-mingas, jei p vertė buvo < 0,05. Rezultatai Minėtu laikotarpiu operuoti 89 pacientai. Dėl vidinio iškritimo -52 (58,4 %), dėl viso storio iškritimo -37 (41,6 %). Vyrų ir moterų santykis buvo 1/6,4, vidutinis amžius -58,3 ± 15,2 metų. Defekografija atlikta 29 (32,6 %) IRP grupės ir 12 (13,5 %) -CRP grupės pacientams (p < 0,001). Septyni (7,9 %) CRP grupės pacientai praeityje buvo operuoti dėl tiesiosios žarnos iškritmo, o IRP grupėje anksčiau operuotų pacientų nebuvo (p=0,02). IRP grupės pacientai buvo operuoti šešiais būdais, o CRP -trimis būd...

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Ventral colporectopexy for overt rectal prolapse and obstructed defaecation syndrome: a systematic review

Abstract: Laparoscopic VR is a safe and effective procedure for ORP and ODS. Longer follow-up is required, and studies comparing VR with standard rectopexy and stapled transanal rectal resection are not yet available.

Cited by 50 publications

References 60 publications

Anatomical and functional changes to the pelvic floor after robotic versus laparoscopic ventral rectopexy: a randomised study

Anatomical and functional changes to the pelvic floor after robotic versus laparoscopic ventral rectopexy: a randomised study

Safety and Efficacy of Laparoscopic Ventral Mesh Rectopexy and Sacrocolpopexy for Rectal Prolapse and Obstructed Defecation: Analysis of First 20 Cases at a UK District General Hospital

Tiesiosios žarnos iškritimo chirurginis gydymas – vieno centro patirtis

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