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Laparoscopic ventral rectopexy for rectal prolapse and symptomatic rectocele: an analysis of 245 consecutive patients
Author(s) -
Formijne Jonkers H. A.,
Poierrié N.,
Draaisma W. A.,
Broeders I. A. M. J.,
Consten E. C. J.
Publication year - 2013
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.12113
Subject(s) - medicine , constipation , rectal prolapse , retrospective cohort study , surgery , cohort , complication , rectum
Aim This retrospective study aimed to determine functional results of laparoscopic ventral rectopexy ( LVR ) for rectal prolapse ( RP ) and symptomatic rectoceles in a large cohort of patients. Method All patients treated between 2004 and 2011 were identified. Relevant patient characteristics were gathered. A questionnaire concerning disease‐related symptoms as well as the Cleveland Clinic Incontinence Score ( CCIS ) and Cleveland Clinic Constipation Score ( CCCS ) was sent to all patients. Results A total of 245 patients underwent operation. Twelve patients (5%) died during follow‐up and were excluded. The remaining patients (224 women, nine men) were sent a questionnaire. Indications for LVR were external RP ( n = 36), internal RP or symptomatic rectocele ( n = 157) or a combination of symptomatic rectocele and enterocele ( n = 40). Mean age and follow‐up were 62 years (range 22–89) and 30 months (range 5–83), respectively. Response rate was 64% (150 patients). The complication rate was 4.6% (11 complications). A significant reduction in symptoms of constipation or obstructed defaecation syndrome was reported (53% of patients before vs 19% after surgery, P < 0.001). Mean CCCS during follow‐up was 8.1 points (range 0–23, SD ± 4.3). Incontinence was reported in 138 (59%) of the patients before surgery and in 32 (14%) of the patients after surgery, indicating a significant reduction ( P < 0.001). Mean CCIS was 6.7 (range 0–19, SD ± 5.2) after surgery. Conclusion A significant reduction of incontinence and constipation or obstructed defaecation syndrome after LVR was observed in this large retrospective study. LVR therefore appears a suitable treatment for RP and rectocele with and without associated enterocele.