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Meta-analysis of laparoscopic mesh rectopexy versus posterior sutured rectopexy for management of complete rectal prolapse

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Objectives

To evaluate comparative outcomes of laparoscopic mesh rectopexy (LMR) and laparoscopic posterior sutured rectopexy (LPSR) in patients with rectal prolapse.

Methods

We conducted a systematic search of electronic databases and bibliographic reference lists with application of a combination of free text and controlled vocabulary search adapted to thesaurus headings, search operators, and limits. Recurrence, Cleveland Clinic Incontinence Score (CCIS), Cleveland Clinic Constipation Score (CCCS), surgical site infections, procedure time, and length of hospital stay were the evaluated outcome measures.

Results

We identified 5 comparative studies reporting a total of 307 patients evaluating outcomes of LMR (n=160) or LPSR (n=147) in patients with rectal prolapse. LMR was associated with significantly lower recurrence rate (OR: 0.28, P=0.009) but longer procedure time (MD: 23.93, P<0.0001) compared to LPSR. However, there was no significant difference in CCIS (MD: −1.02, P=0.50), CCCS (MD: −1.54, P=0.47), surgical site infection (OR: 1.48, P=0.71), and length of hospital stay (MD: −1.54, P=0.47) between two groups. No mesh erosion was reported in any of the included studies at maximum follow-up point. Sub-group analyses with respect to ventral mesh rectopexy, posterior mesh rectopexy, randomised studies, and adult patients were consistent with the main analysis.

Conclusions

LMR seems to be associated with lower recurrence but longer procedure time compared to LPSR. Although no mesh-related complications have been reported by the included studies, no definitive conclusions can be made considering that the included studies were inadequately powered for such outcome. Future high-quality randomised studies with adequate sample size are required.

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Funding

There are no funding sources for this work and no conflicts of interest and financial disclosures for the authors

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Author notes

  1. Shahin Hajibandeh and Shahab Hajibandeh equally contributed to this paper and joined first authorship is proposed.

Authors and Affiliations

  1. Department of General Surgery, Hereford County Hospital, Wye Valley NHS Trust, Hereford, UK

    Shahin Hajibandeh, Chokkalingam Arun, Adedayo Adeyemo & Brendan McIlroy

  2. Department of General Surgery, Wrexham Maelor Hospital, Betsi Cadwaladr University Board, Wrexham, UK

    Shahab Hajibandeh

  3. Department of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK

    Rajeev Peravali

Authors
  1. Shahin Hajibandeh
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  2. Shahab Hajibandeh
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  3. Chokkalingam Arun
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  4. Adedayo Adeyemo
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  5. Brendan McIlroy
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  6. Rajeev Peravali
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Contributions

Conception and design: Shahin H and Shahab H

Literature search and study selection: Shahin H and Shahab H

Data collection: Shahin H and Shahab H

Analysis and interpretation: Shahin H and Shahab H

Writing the article: Shahin H and Shahab H

Critical revision of the article: All authors

Final approval of the article: All authors

Statistical analysis: Shahin H and Shahab H

Corresponding author

Correspondence to Shahin Hajibandeh.

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The authors declare competing interests.

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Appendix

Appendix

Search No

Search strategy*

#1

MeSH descriptor: [mesh rectopexy] explode all trees

#2

mesh rectopexy: TI,AB,KW

#3

MeSH descriptor: [sutured rectopexy] explode all trees

#4

sutured rectopexy: TI,AB,KW

#5

#1 OR #2 OR #3 OR #4

#6

MeSH descriptor: [laparoscopic] explode all trees

#7

laparoscopic: TI,AB,KW

#8

MeSH descriptor: [abdominal rectopexy] explode all trees

#9

abdominal rectopexy: TI,AB,KW

#10

#6 OR #7 OR #8 OR #9

#11

#5 AND #10

  1. *This search strategy was adopted for following databases: MEDLINE, EMBASE, CINAHL, and the Cochrane Central Register of Controlled Trials (CENTRAL)

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Hajibandeh, S., Hajibandeh, S., Arun, C. et al. Meta-analysis of laparoscopic mesh rectopexy versus posterior sutured rectopexy for management of complete rectal prolapse. Int J Colorectal Dis 36, 1357–1366 (2021). https://doi.org/10.1007/s00384-021-03883-0

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  • DOI: https://doi.org/10.1007/s00384-021-03883-0

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