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Long-term annual functional outcome after laparoscopic ventral rectopexy for rectoanal intussusception and/or rectocele: evaluation of sustained improvement

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Abstract

Background

The aim of this study was to assess the long-term annual functional results and quality of life (QOL) after laparoscopic ventral rectopexy (LVR) for rectoanal intussusception (RAI) and/or rectocele.

Methods

This study was a retrospective analysis of prospectively collected data. The study was conducted on patients who underwent LVR for RAI and/or rectocele at our institution between February 2012 and July 2015. The Fecal Incontinence Severity Index (FISI), Constipation Scoring System (CSS), and QOL instruments (i.e., 36-item Short-form Health Survey [SF-36], Patient Assessment of Constipation-QOL [PAC-QOL] scale, and Fecal Incontinence-QOL [FIQL]) were administered before and annually after surgery. The sustainability of substantial symptom improvement (reduction of at least 50% in CSS or FISI scores) postoperatively was evaluated.

Results

Fifty-one patients (median age 76 [range 60–93] years, 48 women [94%]) were analyzed. No mortality or major morbidity occurred. After a median follow-up of 60 months (range 12–84 months), no mesh-related complications occurred. The median CSS and FISI scores were significantly reduced at 1 year and remained significantly reduced for 7 years. In patients who reported symptom scores ≥ 3 times postoperatively, sustained improvement of constipation and fecal incontinence was found in about 50% (18/38) and 75% (26/35) of relevant patients, respectively. All PAC-QOL and FIQL scales significantly improved over time for 5 years. Of the SF-36 scales, four showed significant improvement at 1 year but none was significantly improved after 3 years, except for the social functioning scale.

Conclusions

LVR for RAI and/or rectocele was associated with low morbidity and long-term improvement in symptom-specific QOL. The sustainability of postoperative improvement in fecal incontinence was satisfactory, and that in constipation was fair.

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Acknowledgements

The authors thank Yuko Tsunoda for her assistance with the statistical analysis. We would like to thank Editage (www.editage.jp) for English language editing.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Kameda Medical Center, Kamogawa, Chiba, Japan

    A. Tsunoda, T. Takahashi & H. Kusanagi

  2. Department of Pediatric Surgery, Kameda Medical Center, Kamogawa, Chiba, Japan

    S. Matsuda

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  1. A. Tsunoda
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  2. T. Takahashi
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  3. S. Matsuda
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  4. H. Kusanagi
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Correspondence to A. Tsunoda.

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The authors declare that they have no conflict of interest.

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This study was approved by the Ethics Committee of Kameda Medical Center.

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Informed consent was obtained from all patients. Included in the study.

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Tsunoda, A., Takahashi, T., Matsuda, S. et al. Long-term annual functional outcome after laparoscopic ventral rectopexy for rectoanal intussusception and/or rectocele: evaluation of sustained improvement. Tech Coloproctol 25, 1281–1289 (2021). https://doi.org/10.1007/s10151-021-02499-4

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