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Long-term outcome of laparoscopic rectopexy for full-thickness rectal prolapse

  • H. de BruijnEmail author
  • Y. Maeda
  • K.-N. Tan
  • J. T. Jenkins
  • R. H. Kennedy
Original Article
  • 38 Downloads

Abstract

Background

The aim of this study was to assess the long-term outcomes of laparoscopic rectopexy for full-thickness rectal prolapse (FTRP).

Methods

Data of a prospectively maintained database were analysed. A structured telephone interview was conducted to assess a consecutive series of long-term outcomes of an unselected population who had laparoscopic rectopexy at a single centre between April 2006 and April 2014. The primary outcome was recurrence of FTRP. Secondary outcomes were functional outcomes and morbidity associated with the procedure.

Results

A total of 80 patients (74 female, median age of 66 years, range 23–96 years) underwent a laparoscopic rectopexy, of whom 35 (44%) were for recurrent prolapse. Seventy-two patients (90%) had a posterior suture rectopexy, six (8%) had a ventral mesh rectopexy, one (1%) had a combination of both procedures, and one (1%) had a posterior suture rectopexy with a sacrocolpopexy. There was no conversion to open surgery. Three patients (4%) needed reoperation within 30 days after surgery: two due to small bowel obstruction and one for a suspected port site hernia. Seventy-four patients (93%) were available for either clinical follow-up (FU) or telephone interview and there were 17 (23%) recurrences of FTRP at the median FU of 57 months (range 1–121 months). The median time to recurrence was 12 months (range 1–103 months). Recurrence of FTRP was seen in nine patients (12%) within 1 year following surgery. A history of multiple previous prolapse repairs increased the risk of prolapse recurrence (odds ratio 8.33, 95% confidence interval 1.38–50.47, p = 0.020). Based on clinical follow-up of 71 patients up to 1 year, there were 41 patients (58%) who had faecal incontinence prior to rectopexy of whom two patients (5%) had complete resolution of symptoms and 14 (34%) had improvement.

Conclusions

Laparoscopic rectopexy is a safe operation for full-thickness rectal prolapse. The durability of the repair diminished over time, particularly for patients operated on for recurrent prolapse.

Keywords

Laparoscopic rectopexy Long-term follow-up Rectal prolapse 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was completed as a service audit, approved by the Research and Development Department of the London North West Hospitals NHS Trust.

Informed consent

For this service audit, formal consent is not required in the United Kingdom.

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Sir Alan Parks Physiology UnitSt. Mark’s HospitalHarrowUK
  2. 2.Department of SurgerySt. Mark’s HospitalHarrowUK
  3. 3.Imperial College LondonLondonUK

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