Resection rectopexy for rectal prolapse |
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Authors: | E Xynos E Chrysos J Tsiaoussis E Epanomeritakis J-S Vassilakis |
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Institution: | (1) Department of General Surgery, University Hospital of Heraklion Medical School, University of Crete, GR-711 10 Greece, GR |
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Abstract: | Background: Resection rectopexy through open laparotomy is an established procedure for the treatment of rectal prolapse.
Methods: Resection rectopexy was successfully performed in 10 multiparous women by the laparoscopic approach (LAP), and the results
were compared to those of eight women with laparotomy resection rectopexy (OPEN). Preoperative and postoperative assessment
included anorectal manometry, defecography, and measurement of large-bowel transit.
Results: The duration of the operation was longer in the LAP than in the OPEN group (p < 0.01). Morbidity was lower (p < 0.01) and hospital stay was shorter (p < 0.001) after the LAP than in the OPEN group. Prolapse was cured in all cases. Postoperatively, anal resting and squeeze
pressures and rectal compliance increased significantly in both groups of patients (p= 0.007, p= 0.003, and p < 0.001, respectively). In all patients, the operation resulted in acceleration of large-bowel transit (p < 0.001) and in more obtuse anorectal angles at rest (p= 0.007). In addition, sampling events were observed more commonly (p= 0.008) postoperatively. Preoperatively, incontinence was present in 13 patients (seven LAP and six OPEN) and persisted in
four of them after rectopexy (two LAP and two OPEN).
Conclusions: Resection rectopexy for rectal prolapse can be performed safely via the laparoscopic route. Recovery is uneventful and of
shorter duration after the laparoscopic than after the open approach. Similarly satisfactory functional results are obtained
with both procedures.
Received: 16 February 1998/Accepted: 2 September 1998 |
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Keywords: | : Rectal prolapse — Fecal incontinence — Rectopexy — Colon resection — Laparoscopy |
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