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Irish Journal of Medical Science (1971 -)

, Volume 184, Issue 2, pp 389–393 | Cite as

Open versus laparoscopic abdominal rectopexy: an examination of early postoperative outcomes

  • R. Tevlin
  • A. M. Hanly
  • A. C. Rogers
  • J. M. P. Hyland
  • D. C. Winter
  • A. E. Brannigan
  • P. R. O’Connell
Original Article

Abstract

Background

Abdominal rectopexy is used to treat full thickness rectal prolapse and obstructed defecation syndrome, with good outcomes. Use of a laparoscopic approach may reduce morbidity. The current study assessed short-term operative outcomes for patients undergoing laparoscopic or open rectopexy.

Methods

Rectopexy cases were identified from theater logs in two tertiary referral centers. Patient demographics, intra-operative details and early postoperative outcomes were examined.

Results

There were 62 patients included over 10 years, a third of whom underwent laparoscopic rectopexy. Laparoscopy was associated with a longer operative time (195.9 versus 129.6 min, p = 0.003), but this did not affect postoperative outcomes, with no significant differences found for complication rates and length of stay between the two groups. Univariable analysis found no influence of laparoscopic approach on the likelihood of postoperative complications, and no factor achieved significance with multivariable analysis. This study included the first laparoscopic cases performed in the involved institutions, and a “learning curve” existed as seen with a decreasing operative duration per case over time (p = 0.002).

Conclusions

Laparoscopic rectopexy has similar short-term outcomes to open rectopexy.

Keywords

Laparoscopic Rectopexy Rectal prolapse Obstructed defecation 

Notes

Conflict of interest

None.

References

  1. 1.
    Pemberton JD, Stalker LK (1939) Surgical treatment of complete rectal prolapse. Ann Surg 109(5):799–808CrossRefPubMedCentralPubMedGoogle Scholar
  2. 2.
    Ramanujam PS, Venkatesh KS, Fietz MJ (1994) Perineal excision of rectal procidentia in elderly high-risk patients. A ten-year experience. Dis Colon Rectum 37(10):1027–1030CrossRefPubMedGoogle Scholar
  3. 3.
    Watts JD, Rothenberger DA, Buls JG, Goldberg SM, Nivatvongs S (1985) The management of procidentia. 30 years’ experience. Dis Colon Rectum 28(2):96–102CrossRefPubMedGoogle Scholar
  4. 4.
    Riansuwan W, Hull TL, Bast J, Hammel JP, Church JM (2010) Comparison of perineal operations with abdominal operations for full-thickness rectal prolapse. World J Surg 34(5):1116–1122. doi: 10.1007/s00268-010-0429-0 CrossRefPubMedGoogle Scholar
  5. 5.
    Tsiaoussis J, Chrysos E, Athanasakis E, Pechlivanides G, Tzortzinis A, Zoras O, Xynos E (2005) Rectoanal intussusception: presentation of the disorder and late results of resection rectopexy. Dis Colon Rectum 48(4):838–844. doi: 10.1007/s10350-004-0850-2 CrossRefPubMedGoogle Scholar
  6. 6.
    Pescatori M (2009) Long-term follow-up of simultaneous abdominoperineal repair of enterorectocele and internal mucosal prolapse. Dis Colon Rectum 52(2):327–335. doi: 10.1007/DCR.0b013e31819a21d8 CrossRefPubMedGoogle Scholar
  7. 7.
    Jayne DG, Schwandner O, Stuto A (2009) Stapled transanal rectal resection for obstructed defecation syndrome: one-year results of the European STARR Registry. Dis Colon Rectum 52(7):1205–1212. doi: 10.1007/DCR.0b013e3181a9120f discussion 1212–1204CrossRefPubMedGoogle Scholar
  8. 8.
    Kohler K, Stelzner S, Hellmich G, Lehmann D, Jackisch T, Fankhanel B, Witzigmann H (2012) Results in the long-term course after stapled transanal rectal resection (STARR). Langenbeck’s Arch Surg 397(5):771–778. doi: 10.1007/s00423-012-0920-1 CrossRefGoogle Scholar
  9. 9.
    Guller U, Jain N, Hervey S, Purves H, Pietrobon R (2003) Laparoscopic vs open colectomy: outcomes comparison based on large nationwide databases. Arch Surg 138(11):1179–1186. doi: 10.1001/archsurg.138.11.1179 CrossRefPubMedGoogle Scholar
  10. 10.
    Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, Heath RM, Brown JM (2005) Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet 365(9472):1718–1726. doi: 10.1016/S0140-6736(05)66545-2 CrossRefPubMedGoogle Scholar
  11. 11.
    Kuhry E, Schwenk W, Gaupset R, Romild U, Bonjer J (2008) Long-term outcome of laparoscopic surgery for colorectal cancer: a Cochrane systematic review of randomised controlled trials. Cancer Treat Rev 34(6):498–504. doi: 10.1016/j.ctrv.2008.03.011 CrossRefPubMedGoogle Scholar
  12. 12.
    Delaney CP, Kiran RP, Senagore AJ, Brady K, Fazio VW (2003) Case-matched comparison of clinical and financial outcome after laparoscopic or open colorectal surgery. Ann Surg 238(1):67–72. doi: 10.1097/01.sla.0000074967.53451.22 PubMedCentralPubMedGoogle Scholar
  13. 13.
    Sajid MS, Siddiqui MR, Baig MK (2010) Open vs laparoscopic repair of full-thickness rectal prolapse: a re-meta-analysis. Colorectal Dis: Off J Assoc Coloproctology G B Irel 12(6):515–525. doi: 10.1111/j.1463-1318.2009.01886.x CrossRefGoogle Scholar
  14. 14.
    Schlachta CM, Mamazza J, Seshadri PA, Cadeddu M, Gregoire R, Poulin EC (2010) Defining a learning curve for laparoscopic colorectal resections. Dis Colon Rectum 44(2):217–222CrossRefGoogle Scholar
  15. 15.
    Procter LD, Davenport DL, Bernard AC, Zwischenberger JB (2010) General surgical operative duration is associated with increased risk-adjusted infectious complication rates and length of hospital stay. J Am Coll Surg 210(1):60–65. doi: 10.1016/j.jamcollsurg.2009.09.034 e61–e62CrossRefPubMedGoogle Scholar
  16. 16.
    Solomon MJ, Young CJ, Eyers AA, Roberts RA (2002) Randomized clinical trial of laparoscopic versus open abdominal rectopexy for rectal prolapse. Br J Surg 89(1):35–39. doi: 10.1046/j.0007-1323.2001.01957.x CrossRefPubMedGoogle Scholar

Copyright information

© Royal Academy of Medicine in Ireland 2014

Authors and Affiliations

  • R. Tevlin
    • 1
    • 2
  • A. M. Hanly
    • 1
  • A. C. Rogers
    • 1
  • J. M. P. Hyland
    • 1
  • D. C. Winter
    • 1
  • A. E. Brannigan
    • 2
  • P. R. O’Connell
    • 1
  1. 1.Centre for Colorectal DiseaseSt. Vincent’s University HospitalDublin 4Ireland
  2. 2.Mater Misericordiae University HospitalDublin 7Ireland

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