Abstract
Background
This study aimed to compare ventral mesh rectopexy (VMR) and pelvic organ prolapse suspension surgery (POPS) in management of patients presenting with rectal prolapse.
Methods
Our study was a prospective cohort trial in which 120 female patients with complete rectal prolapse were included, 60 patients had had VMR and the other 60 had had POPS as a surgical management for complete rectal prolapse. Results had been compared 6 months postoperatively regarding operative time, postoperative pain, hospital stay, complications of surgery including recurrence of the rectal prolapse, the efficacy of each operation in treatment of rectal prolapse and associated symptoms.
Results
The patients were assessed 6 months postoperatively. There was no significant statistical difference regarding hospital stay and postoperative pain. Operative time was significantly shorter in POPS in comparison with VMR (P value < 0.05). VMR showed slight improvement regarding constipation and continence scores; however, this was statistically significant. VMR showed less complications compared to POPS. Complications with rectopexy happened only with 4 patients compared to 24 patients in POPS groups, 2 cases of recurrence in rectopexy group compared to 6 cases of recurrence in POPS.
Conclusion
POPS is comparable to VMR in management of rectal prolapse and in improving the ODS symptoms. Thus, POPS can be used as easier, faster option to treat rectal prolapse in selected patients.
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This directed to Faculty of medicine, Cairo University, who completely funded this research.
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Appendix A
Appendix A
Preoperative preparation: All patients were given enema at the night before the operation and one hour before the operation; patients were risk assessed for thromboembolic events and prescribed thromboembolic deterrent (TED) stockings and low molecular weight heparin as appropriate, the administration of which is determined after the surgical procedure. Prophylactic antimicrobials were administered at induction; in our unit, amoxicillin 1 g, metronidazole 500 mg (ideal body weight) IV are given to non-penicillin allergic patients.
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Farag, A., Mashhour, A.N., Raslan, M. et al. Laparoscopic Pelvic Organ Prolapse Suspension (Pops) Versus Laparoscopic Ventral Mesh Rectopexy for Treatment of Rectal Prolapse: Prospective Cohort Study. World J Surg 44, 3158–3166 (2020). https://doi.org/10.1007/s00268-020-05585-0
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DOI: https://doi.org/10.1007/s00268-020-05585-0