Abstract
PURPOSE: Abdominal rectopexy without sigmoid resection is usually associated with a hospital stay of four to ten days. Recent developments have shown that a multimodal rehabilitation program with epidural analgesia and early oral feeding and mobilization will reduce hospital stay after colonic resection. The aim of this study was to describe the results after abdominal rectopexy with a multimodal rehabilitation program. METHODS: Thirty-one consecutive patients with rectal prolapse, median age 69 (range, 24–85) years and including 14 patients of American Society of Anesthesiologists physical status III to IV, were scheduled for abdominal rectopexy with a multimodal rehabilitation program including 48 hours thoracic epidural analgesia or patient-controlled anesthesia (3 patients), early oral nutrition and mobilization, and a planned two-day postoperative hospital stay. Follow-up was done at two months postoperatively. RESULTS: All patients except one tolerated normal diet and were mobilized to the same level as before surgery on the first postoperative day. Bowel movement was reestablished at a median of Day 2, and median postoperative hospital stay was three (mean, 4.4) days. At two months follow-up 16 percent were incontinent vs. 74 percent before surgery. Constipation was noted in 43 percent before surgery vs. 28 percent at two months follow-up. CONCLUSION: Median hospital stay after abdominal rectopexy may be reduced to three days with postoperative multimodal rehabilitation.
Similar content being viewed by others
References
R Baker AJ Senagore MA Luchtefeld (1995) ArticleTitleLaparoscopic-assisted vs. open resection Dis Colon Rectum 38 199–201
MJ Solomon AA Eyers (1996) ArticleTitleLaparoscopic rectopexy using mesh fixation with spiked chromium staple Dis Colon Rectum 39 279–284
P Boccasanta R Rosanti M Venturi et al. (1998) ArticleTitleComparison of laparoscopic rectopexy with open technique in the treatment of complete rectal prolapse Surg Laparosc Endosc 8 460–465
AR Stevenson RW Stitz JW Lumley (1998) ArticleTitleLaparoscopic-assisted resection-rectopexy for rectal prolapse Dis Colon Rectum 41 46–54
IH Kellokumpu J Vironen T Scheinin (2000) ArticleTitleLaparoscopic repair of rectal prolapse. A prospective study evaluating surgical outcome and changes in symptoms and bowel function Surg Endosc 14 634–640
H Kehlet (1997) ArticleTitleMultimodal approach to control postoperative pathophysiology and recovery Br J Anaesth 78 606–617
L Basse DH Jakobsen P Billesbølle MU Werner H Kehlet (2000) ArticleTitleA clinical pathway to accelerate recovery after colonic resection Ann Surg 232 51–57
JR Cuthbertson JA Smith (1988) ArticleTitleAn abdominal repair for rectal prolapse Aust N Z J Surg 58 499–503
K Yoshioka F Heyen MR Keighley (1989) ArticleTitleFunctional results after posterior abdominal rectopexy for rectal prolapse Dis Colon Rectum 32 835–838
JL McCue JP Thomson (1991) ArticleTitleClinical and functional results of abdominal rectal prolapse Br J Surg 78 921–923
JR Anderson BG Wilson TG Parks (1984) ArticleTitleComplete rectal prolapse—the results of Ivalon sponge rectopexy Postgrad Med J 60 411–414
BG Bradshaw SS Liu RC Thirlby (1998) ArticleTitleStandardized perioperative care protocols and reduced length of stay after colonic surgery J Am Coll Surg 186 501–506
Author information
Authors and Affiliations
About this article
Cite this article
Basse, L., Billesbølle, P. & Kehlet, H. Early Recovery After Abdominal Rectopexy with Multimodal Rehabilitation. Dis Colon Rectum 45, 195–199 (2002). https://doi.org/10.1007/s10350-004-6145-9
Issue Date:
DOI: https://doi.org/10.1007/s10350-004-6145-9