International Journal of Colorectal Disease

, Volume 7, Issue 4, pp 219–222 | Cite as

Abdominal rectopexy with sigmoidectomy vs. rectopexy alone for rectal prolapse: A prospective, randomized study

  • P. Luukkonen
  • U. Mikkonen
  • H. Järvinen
Original Articles

Abstract

A prospective, randomized study comparing abdominal rectopexy and sigmoid resection (Group I; n=15) with polyglycolic acid mesh rectopexy without sigmoidectomy (Group II; n=15) for complete rectal prolapse was carried out. One patient in Group I died of myocardial infarction, one patient in Group II had a small bowel obstruction and two patients in Group I an asymptomatic stricture of the anastomosis. Otherwise a safe and efficient control of the prolapse was achieved in both groups. Eleven (73%) patients in Group I and 12 (80%) patients in Group II were more or less incontinent before surgery. After correction of prolapse incontinence improved in eight and ten patients in Groups I and II, but became slightly worse in one patient in Group II. A similar rise in anal pressures was measured in both groups after surgery. Constipation disappeared in three and seven patients in Groups I and II six months after surgery, but five additional patients in Group II became severely constipated and colectomy had to be performed in one of them. Surgery caused no significant change in colonic transit times even though increased transit times were measured in each group six months postoperatively. Sigmoid resection in conjunction with rectopexy does not seem to increase operative morbidity but tends to diminish postoperative constipation possibly by causing less outlet obstruction.

Résumé

Une étude prospective randomisée a été faite comparant la rectopexie abdominale avec résection sigmoïdienne (groupe I n-15) avec la rectopexie utilisant une mèche d'acide polyglycolique sans sigmoïdectomie (groupe II n=15) pour traiter le prolapsus rectal complet. Un patient du groupe I est mort d'infarctus du myocarde, un patient du groupe II a eu une occlusion intestinale et deux patients du groupe II une sténose asymptomatique de leur anastomose. Par ailleurs un contrôle sur et efficace du prolapsus a été obtenu dans les deux groupes. 11 (73%) patients du groupe I et 12 (80%) patients du groupe II étaient plus ou moins incontinents avant l'opération. Après correction du prolapsus l'incontinence s'est amélioré chez 8 et 10 patients respectivement, mais a augmenté légèrement chez un patient du groupe II. Une augmentation similaire des pressions anales a été constatée dans les deux groupes après chirugie. La constipation a disparu chez 3 et 7 patients des groupes I et II six mois après chirurgie mais 5 patients supplémentaires du groupe II ont développé une constipation sévère et une colectomie a dû être pratiquée chez un d'entre eux. La chirurgie n'a provoqué aucune modification significative du temps de transit colique même un temps de transit augmenté a été trouvé dans chacun des groupes six mois après l'opération. La résection sigmoïdienne associée à la rectopexie ne semble pas augmenter la morbidité opératoire mais tend à diminuer la constipation postopératoire peut-être en diminuant l'obstruction terminale.

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Copyright information

© Springer-Verlag 1992

Authors and Affiliations

  • P. Luukkonen
    • 1
  • U. Mikkonen
    • 1
  • H. Järvinen
    • 1
  1. 1.Second Department of SurgeryUniversity Central HospitalHelsinkiFinland

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