Laparoscopic Ventral Rectopexy: a Prospective Long-term Evaluation of Functional Results and Quality of Life

Overview

Journal Tech Coloproctol

Date 2013 Jan 25

PMID 23345041

Citations 21

Authors

L Maggiori

F Bretagnol

M Ferron

Y Panis

Affiliations

Soon will be listed here.

Abstract

Background: Laparoscopic ventral rectopexy for rectal prolapse combines the advantages of a minimally invasive approach with the low recurrence rate observed after abdominal procedures. To date, only a few long-term functional studies and no quality of life assessment are available. The aim of this study was to assess long-term functional outcomes and quality of life after laparoscopic ventral rectopexy.

Methods: Between January 2007 and December 2008, patients who underwent laparoscopic ventral rectopexy for full-thickness external rectal prolapse and/or rectocele were prospectively included. Fecal incontinence and constipation were scored (Wexner score and Rome II criteria). Quality of life was assessed using the gastrointestinal quality of life form (GIQLI).

Results: Thirty-three patients were included and 30 (91 %) completed all the questionnaires. There was no morbidity or mortality. The mean length of hospital stay was 5 ± 1 days (range 3-7 days). After a mean follow-up of 42 ± 7 months (range 32-52 months), recurrence of rectocele was observed in two patients (6 %). At the end of follow-up, constipation was improved in 13/18 patients (72 %) and two patients (7 %) presented de novo constipation. The patients' Wexner score improved between preoperative status and end of follow-up (12 ± 7 vs. 4 ± 3, p = 0.002). Compared to the preoperative score, quality of life significantly improved over time: 77 ± 21 preoperatively versus 107 ± 17 at 1 year versus 109 ± 18 at the end of follow-up (p < 0.001).

Conclusions: This prospective study showed that laparoscopic ventral rectopexy was associated with excellent postoperative outcomes and a low long-term recurrence rate. Long-term functional results were excellent in terms of continence, with significant improvement of quality of life and without worsening constipation.

Citing Articles

Mesh-associated complications in minimally invasive ventral mesh rectopexy: a systematic review.

Hess G, Nocera F, Taha-Mehlitz S, Christen S, von Strauss Und Torney M, Steinemann D Surg Endosc. 2024; 38(12):7073-7082.

PMID: 39516323 PMC: 11614941. DOI: 10.1007/s00464-024-11369-7.

Quality of life in benign colorectal disease-a review of the assessment with the Gastrointestinal Quality of Life Index (GIQLI).

Fuchs K, Musial F, Retzbach L, Hann A, Meining A Int J Colorectal Dis. 2023; 38(1):172.

PMID: 37338676 PMC: 10282040. DOI: 10.1007/s00384-023-04473-y.

van der Schans E, Boom M, El Moumni M, Verheijen P, Broeders I, Consten E Tech Coloproctol. 2021; 26(2):85-98.

PMID: 34812970 PMC: 8763765. DOI: 10.1007/s10151-021-02534-4.

Predictive Factors for Recurrence of External Rectal Prolapse after Laparoscopic Ventral Rectopexy.

Tsunoda A, Takahashi T, Matsuda S, Kusanagi H J Anus Rectum Colon. 2021; 5(4):376-385.

PMID: 34746502 PMC: 8553359. DOI: 10.23922/jarc.2021-024.

Suture rectopexy versus ventral mesh rectopexy for complete full-thickness rectal prolapse and intussusception: systematic review and meta-analysis.

Lobb H, Kearsey C, Ahmed S, Rajaganeshan R BJS Open. 2021; 5(1).

PMID: 33609376 PMC: 7893464. DOI: 10.1093/bjsopen/zraa037.

References

Portier G, Kirzin S, Cabarrot P, Queralto M, Lazorthes F . The effect of abdominal ventral rectopexy on faecal incontinence and constipation in patients with internal intra-anal rectal intussusception. Colorectal Dis. 2010; 13(8):914-7. DOI: 10.1111/j.1463-1318.2010.02327.x. View

DHoore A, Cadoni R, Penninckx F . Long-term outcome of laparoscopic ventral rectopexy for total rectal prolapse. Br J Surg. 2004; 91(11):1500-5. DOI: 10.1002/bjs.4779. View

Sezai D, Demirbas S, Akin L, Kurt Y, Ogun I, Celenk T . The impact of laparoscopic resection rectopexy in patients with total rectal prolapse. Mil Med. 2005; 170(9):743-7. DOI: 10.7205/milmed.170.9.743. View

Wong M, Meurette G, Abet E, Podevin J, Lehur P . Safety and efficacy of laparoscopic ventral mesh rectopexy for complex rectocele. Colorectal Dis. 2010; 13(9):1019-23. DOI: 10.1111/j.1463-1318.2010.02349.x. View

Thompson W, Longstreth G, Drossman D, Heaton K, Irvine E, Muller-Lissner S . Functional bowel disorders and functional abdominal pain. Gut. 1999; 45 Suppl 2:II43-7. PMC: 1766683. DOI: 10.1136/gut.45.2008.ii43. View

Tou S, Brown S, Malik A, Nelson R . Surgery for complete rectal prolapse in adults. Cochrane Database Syst Rev. 2008; (4):CD001758. DOI: 10.1002/14651858.CD001758.pub2. View

DHoore A, Penninckx F . Laparoscopic ventral recto(colpo)pexy for rectal prolapse: surgical technique and outcome for 109 patients. Surg Endosc. 2006; 20(12):1919-23. DOI: 10.1007/s00464-005-0485-y. View

JORGE J, Wexner S . Etiology and management of fecal incontinence. Dis Colon Rectum. 1993; 36(1):77-97. DOI: 10.1007/BF02050307. View

Luukkonen P, Mikkonen U, Jarvinen H . Abdominal rectopexy with sigmoidectomy vs. rectopexy alone for rectal prolapse: a prospective, randomized study. Int J Colorectal Dis. 1992; 7(4):219-22. DOI: 10.1007/BF00341225. View

10.

Samaranayake C, Luo C, Plank A, Merrie A, Plank L, Bissett I . Systematic review on ventral rectopexy for rectal prolapse and intussusception. Colorectal Dis. 2009; 12(6):504-12. DOI: 10.1111/j.1463-1318.2009.01934.x. View

11.

Purkayastha S, Tekkis P, Athanasiou T, Aziz O, Paraskevas P, Ziprin P . A comparison of open vs. laparoscopic abdominal rectopexy for full-thickness rectal prolapse: a meta-analysis. Dis Colon Rectum. 2005; 48(10):1930-40. DOI: 10.1007/s10350-005-0077-x. View

12.

Madiba T, Baig M, Wexner S . Surgical management of rectal prolapse. Arch Surg. 2005; 140(1):63-73. DOI: 10.1001/archsurg.140.1.63. View

13.

Slim K, Bousquet J, Kwiatkowski F, Lescure G, Pezet D, Chipponi J . [First validation of the French version of the Gastrointestinal Quality of Life Index (GIQLI)]. Gastroenterol Clin Biol. 1999; 23(1):25-31. View

14.

Solomon M, Young C, Eyers A, Roberts R . Randomized clinical trial of laparoscopic versus open abdominal rectopexy for rectal prolapse. Br J Surg. 2002; 89(1):35-9. DOI: 10.1046/j.0007-1323.2001.01957.x. View

15.

Wijffels N, Cunningham C, Dixon A, Greenslade G, Lindsey I . Laparoscopic ventral rectopexy for external rectal prolapse is safe and effective in the elderly. Does this make perineal procedures obsolete?. Colorectal Dis. 2010; 13(5):561-6. DOI: 10.1111/j.1463-1318.2010.02242.x. View

16.

Lauretta A, Bellomo R, Galanti F, Tonizzo C, Infantino A . Laparoscopic low ventral rectocolpopexy (LLVR) for rectal and rectogenital prolapse: surgical technique and functional results. Tech Coloproctol. 2012; 16(6):477-83. DOI: 10.1007/s10151-012-0918-2. View

17.

Kim M, Reibetanz J, Boenicke L, Germer C, Jayne D, Isbert C . Quality of life after laparoscopic resection rectopexy. Int J Colorectal Dis. 2011; 27(4):489-95. DOI: 10.1007/s00384-011-1332-3. View

18.

Bachoo P, Brazzelli M, Grant A . Surgery for complete rectal prolapse in adults. Cochrane Database Syst Rev. 2000; (2):CD001758. DOI: 10.1002/14651858.CD001758. View

19.

Boons P, Collinson R, Cunningham C, Lindsey I . Laparoscopic ventral rectopexy for external rectal prolapse improves constipation and avoids de novo constipation. Colorectal Dis. 2009; 12(6):526-32. DOI: 10.1111/j.1463-1318.2009.01859.x. View

20.

Yoshioka K, Heyen F, Keighley M . Functional results after posterior abdominal rectopexy for rectal prolapse. Dis Colon Rectum. 1989; 32(10):835-8. DOI: 10.1007/BF02554550. View