Skip to main content
SpringerLink
Log in

Laparoscopic ventral mesh rectopexy in the oldest old is safe: the race is run

  • Original Article
  • Published:
Techniques in Coloproctology Aims and scope Submit manuscript

Abstract

Background

Laparoscopic ventral mesh rectopexy (LVMR) is considered to be the gold standard for managing rectal prolapse. Nevertheless, concerns have been expressed about the use of this procedure in elderly patients. The aim of the current study was to examine the perioperative safety of primary LVMR operations in the oldest old in comparison to younger individuals and to assess our hospital policy of offering LVMR to all patients, regardless of age and morbidity.

Methods

A retrospective study analysed demographic information, operation notes, meshes utilised, operation times, lengths of hospital stay (LOS) and American Society of Anesthesiologists (ASA) scores of patients who underwent LVMR at Elisabeth-TweeSteden Hospital between 2012 and 2023.

Results

Eighty-seven female patients underwent LVMR. Nineteen patients were 80 years of age or older (OLD group); the remaining 65 patients were under the age of 80 (YOUNG group). The difference between the groups in terms of age was statistically significant. ASA scores were not significantly different. No mortality was observed. There was no statistically significant difference between the groups in terms of LOS, operation time or morbidity. Moreover, the postoperative morbidity profile was excellent in both groups.

Conclusion

LVMR seems to be a safe operation for the “oldest old” patients with comorbidity, despite a single-centre, retrospective trial with limited follow-up. The present study suggests abandoning the dogma that “frail patients with rectal prolapse are not suitable for laparoscopic ventral mesh rectopexy.”

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Data availability

The datasets analysed during the current study are available from the corresponding author on reasonable request.

References

  1. D’Hoore A, Penninckx F (2006) Laparoscopic ventral recto (colpo) pexy for rectal prolapse: surgical technique and outcome for 109 patients. Surg Endosc 20:1919–1923. https://doi.org/10.1007/s00464-005-0485-y

    Article  PubMed  Google Scholar 

  2. Boons P,  Collinson R,  Cunningham C, Lindsey I (2010) Laparoscopic ventral rectopexy for external rectal prolapse improves constipation and avoids de novo constipation. Colorectal Dis 12(6):526–532. https://doi.org/10.1111/j.1463-1318.2009.01859.x

    Article  CAS  PubMed  Google Scholar 

  3. Carpelan-Holmström M, Kruuna O, Scheinin T (2006) Laparoscopic rectal prolapse surgery combined with short hospital stay is safe in elderly and debilitated patients. Surg Endosc 20:1353–1359. https://doi.org/10.1007/s00464-005-0217-3

    Article  PubMed  Google Scholar 

  4. Solomon MJ,  Young CJ, Eyers AA, Roberts RA (2002) Randomised clinical trial of laparoscopic versus open abdominal rectopexy for rectal prolapse. Wiley Online Library, Hoboken

    Google Scholar 

  5. Randall J, Smyth E, McCarthy K, Dixon AR (2014) Outcome of laparoscopic ventral mesh rectopexy for external rectal prolapse. Colorectal Dis 16(11):914–919. https://doi.org/10.1111/codi.12741

    Article  CAS  PubMed  Google Scholar 

  6. Gultekin FA, Wong MT, Podevin J et al (2015) Safety of laparoscopic ventral rectopexy in the elderly: results from a nationwide database. Dis Colon Rectum 58(3):339–343. https://doi.org/10.1097/DCR.0000000000000308

    Article  PubMed  Google Scholar 

  7. Gustafsson U, Scott MJ, Hubner M et al (2019) Guidelines for perioperative care in elective colorectal surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations: 2018. World J Surg 43:659–695. https://doi.org/10.1007/s00268-018-4844-y

    Article  CAS  PubMed  Google Scholar 

  8. Wijffels N, Cunningham C, Dixon A, Greenslade G, Lidsey I (2011) Laparoscopic ventral rectopexy for external rectal prolapse is safe and effective in the elderly. Does this make perineal procedures obsolete? Colorectal Dis 13(5):561–566. https://doi.org/10.1111/j.1463-1318.2010.02242.x

    Article  CAS  PubMed  Google Scholar 

  9. Tsunoda A, Takahashi T, Matsuda S, Oka N, Kusanagi H (2020) Midterm functional outcome after laparoscopic ventral rectopexy for external rectal prolapse. Asian J Endosc Surg 13(1):25–32. https://doi.org/10.1111/ases.12701

    Article  PubMed  Google Scholar 

  10. Daniel VT, Davids JS, Sturrock PR, Maykel JA, Phatak UR, Alavi K (2019) Getting to the bottom of treatment of rectal prolapse in the elderly: analysis of the National Surgical Quality Improvement Program (NSQIP). Am J Surg 218(2):288–292. https://doi.org/10.1016/j.amjsurg.2019.02.010

    Article  PubMed  Google Scholar 

  11. Madbouly KM, Mohii AD (2019) Laparoscopic ventral rectopexy versus stapled transanal rectal resection for treatment of obstructed defecation in the elderly: long-term results of a prospective randomized study. Dis Colon Rectum 62(1):47–55. https://doi.org/10.1097/DCR.0000000000001256

    Article  PubMed  Google Scholar 

  12. Bjerke T, Mynster T (2014) Laparoscopic ventral rectopexy in an elderly population with external rectal prolapse: clinical and anal manometric results. Int J Colorectal Dis 29:1257–1262. https://doi.org/10.1007/s00384-014-1960-5

    Article  PubMed  Google Scholar 

  13. Tou S, Brown SR, Malik AI, Nelson RL(2008) Surgery for complete rectal prolapse in adults. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD001758.pub2

    Article  PubMed  Google Scholar 

  14. Boccasanta P, Rosati R, Venturi M et al (1998) Comparison of laparoscopic rectopexy with open technique in the treatment of complete rectal prolapse: clinical and functional results. Surg Laparosc Endosc 8(6):460–465. https://doi.org/10.1111/j.1463-1318.2010.02242.x

    Article  CAS  PubMed  Google Scholar 

  15. Emile S, Elbanna H, Youssef M et al (2017) Laparoscopic ventral mesh rectopexy vs Delorme’s operation in management of complete rectal prolapse: a prospective randomized study. Colorectal Dis 19(1):50–57. https://doi.org/10.1111/codi.13399

    Article  CAS  PubMed  Google Scholar 

  16. Albayati S, Chen P, Morgan MJ, Toh JWT (2019) Robotic vs. laparoscopic ventral mesh rectopexy for external rectal prolapse and rectal intussusception: a systematic review. Tech Coloproctol 23(6):529–535. https://doi.org/10.1007/s10151-019-02014-w

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

There was no external funding source for the research.

Author information

Authors and Affiliations

  1. Department of Surgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands

    E. Ergüder, C. Verkade, D. K. Wasowicz, B. S. Langenhoff & D. D. E. Zimmerman

  2. Department of Surgery, H. S. U. Ankara Training and Research Hospital, Ankara, Türkiye

    E. Ergüder & S. Altiner

Authors
  1. E. Ergüder
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C. Verkade
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. D. K. Wasowicz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. B. S. Langenhoff
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. S. Altiner
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. D. D. E. Zimmerman
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

EE and DZ wrote the main manuscript. DZ is the surgeon of all patients. SA did the statistical analyses. DW and BL contributed to discussion part. EE and CV mined the data. All authors reviewed the manuscript.

Corresponding author

Correspondence to D. D. E. Zimmerman.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

This research study was conducted retrospectively from data obtained for clinical purposes. Approval from the ethical review board was not required for this study.

Informed consent

For this type of study formal consent is not required.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ergüder, E., Verkade, C., Wasowicz, D.K. et al. Laparoscopic ventral mesh rectopexy in the oldest old is safe: the race is run. Tech Coloproctol 28, 46 (2024). https://doi.org/10.1007/s10151-024-02920-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s10151-024-02920-8

Keywords

Search

Navigation