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Long-term results and functional outcome after ripstein rectopexy

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Diseases of the Colon & Rectum

Abstract

PURPOSE: The aim of this study was to evaluate operative mortality, morbidity, and functional results after Ripstein rectopexy for rectal prolapse and internal rectal intussusception. METHODS: Sixty-nine patients with rectal prolapse and 43 with internal rectal intussusception were included. All patient records were studied and complications registered. Long-term follow-up was possible in 105 patients and performed by clinical examination and standardized interview, telephone interview, or patient records. Seventy-six patients were prospectively evaluated, comparing bowel function before and after rectopexy. RESULTS: There was no operative mortality. Operative morbidity was 33 percent, and most complications were minor. Severe early complications included one large-bowel obstruction and one transient ureteric stenosis. Median time of follow-up was seven years in patients with rectal prolapse and 5.4 years in patients with internal rectal intussusception. Late complications included two rectovaginal fistulas and one lethal sigmoid fecaloma. Five patients underwent subtotal colectomy for severe constipation. There was one recurrent prolapse (1.6 percent). Functional evaluation showed that incontinence improved (P=0.049), whereas the number of bowel movements per week decreased (P<0.001). Frequency of emptying difficulties did not change significantly in patients with rectal prolapse but increased in patients with internal rectal intussusception (P=0.038). CONCLUSION: Ripstein rectopexy can be performed with low mortality and recurrence rate, but with a high early complication rate. There were also some serious late complications. Continence was improved, although increased constipation was a problem in some patients, especially among those with internal rectal intussusception.

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Authors and Affiliations

  1. From the Department of Surgery, Karolinska Institutet at Danderyd Hospital, Stockholm, Sweden

    Inkeri Schultz M.D., Ph.D., Anders Mellgren M.D., Ph.D., Anders Dolk M.D., Ph.D., Claes Johansson M.D., Ph.D. & Bo Holmström M.D., Ph.D.

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  1. Inkeri Schultz M.D., Ph.D.
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  2. Anders Mellgren M.D., Ph.D.
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  3. Anders Dolk M.D., Ph.D.
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  4. Claes Johansson M.D., Ph.D.
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  5. Bo Holmström M.D., Ph.D.
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Additional information

Supported by grants from “Förenade Liv” Mutual Group Life Insurance Company, Stockholm, Sweden; Kjell and Märta Beijer's foundation; Marianne and Marcus Wallenberg's foundation; KI foundations; and Bert von Kantzow's research foundation.

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Schultz, I., Mellgren, A., Dolk, A. et al. Long-term results and functional outcome after ripstein rectopexy. Dis Colon Rectum 43, 35–43 (2000). https://doi.org/10.1007/BF02237241

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