Institution: | (1) Departments of General Surgery and Radiology, University Hospital, Tübingen, Germany;(2) Department of General Surgery, University Hospital, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany |
Abstract: | We investigated the functional results after laparoscopic rectopexy for rectal prolapse in 29 patients at least 12 months
postoperatively. Twenty patients were evaluated completely pre- and postoperatively (median 22 months postoperatively, range
12 to 54 months). Six patients were interviewed by telephone, two patients were lost to follow-up, and one patient died of
causes unrelated to rectal prolapse. Patients underwent a proctologic examination, anoscopy, rigid sigmoidoscopy, fluoroscopic
defecography, and anorectal manometry pre- and postoperatively, and an additional standardized interview postoperatively.
Anorectal manometry showed a significant increase in maximum anal resting and squeeze pressures postoperatively (resting pressure
72 ±8 vs. 95 ±13 mm Hg, pre- vs. postoperatively; P = 0.046; squeeze pressure 105 ±17 vs. 142 ±19 mm Hg, pre- vs. postoperatively; P = 0.035), and continence improved postoperatively (Wexner incontinence score 6.0 ±1.0 vs. 3.9 ± 0.8 pre- vs. postoperatively,
P = 0.02). Twenty (77%) of 26 patients were satisfied with the operative result, but functional morbidity was observed in four
patients, with two patients complaining of severe evacuation problems. Rectal prolapse recurred in one patient 42 months postoperatively
(recurrence rate 1 3.8%] of 26 patients). Functional results were very similar to those obtained after open rectopexy, with
symptoms of prolapse and incontinence improved in the great majority of patients.
Presented at the Fortieth Annual Meeting of The Society for Surgery of the Alimentary Tract, Orlando, Fla., May 16–19, 1999. |