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Surgery for Rectal Prolapse: Orr-Loygue Ventral Rectopexy With Limited Dissection Prevents Postoperative-Induced Constipation Without Increasing Recurrence

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Diseases of the Colon & Rectum

Purpose

Abdominal rectopexy is the preferred surgical technique for the treatment of total rectal prolapse. In many reported series, its results are impaired by induced constipation. Lateral rectal ligaments preservation could prevent constipation but increase recurrence rates. We report anatomic and functional results of abdominal Orr-Loygue ventral rectopexy with dissection limited to anterior and posterior rectal wall.

Methods

Consecutive patients with total rectal prolapse or intra-anal rectal prolapse associated to fecal incontinence or outlet obstruction were treated by abdominal rectopexy. Recurrences, correction of symptoms, and induced constipation were prospectively analyzed.

Results

Seventy-three patients were treated between 1993 and 2004. Recurrence was observed in 3 of 73 patients (4.1 percent) after a mean follow-up period of 28.6 (range, 6–84) months. Overall patient satisfaction (correction of prolapse, incontinence, and/or outlet obstruction) after the procedure was classified in three categories: Cured: n = 45 (61.6 percent); Improved: n = 24 (32.9 percent); Failure: n = 4 (5.5 percent). Postoperative constipation appeared in 2 of 36 (5.5 percent) preoperatively nonconstipated patients and worsened in 2 of 37 (5.4 percent) preoperatively constipated patients.

Conclusions

Orr-Loygue abdominal ventral rectopexy with limited dissection and preservation of rectal lateral ligaments is a safe and effective procedure for the treatment of complete rectal prolapse, or internal prolapse associated with fecal incontinence or outlet obstruction. Preservation of lateral ligaments seems to prevent postoperative constipation without increasing the risk of prolapse recurrence.

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Authors and Affiliations

  1. Digestive Surgery Unit, Pr. Lazorthes, CHU Purpan, Toulouse, France

    Guillaume Portier M.D., Francesco Iovino M.D. & Franck Lazorthes M.D.

  2. Service de Chirurgie Digestive, CHU Purpan, place du Dr. Baylac, Toulouse cedex, 31059, France

    Guillaume Portier M.D.

Authors
  1. Guillaume Portier M.D.
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  2. Francesco Iovino M.D.
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  3. Franck Lazorthes M.D.
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Correspondence to Guillaume Portier M.D..

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Portier, G., Iovino, F. & Lazorthes, F. Surgery for Rectal Prolapse: Orr-Loygue Ventral Rectopexy With Limited Dissection Prevents Postoperative-Induced Constipation Without Increasing Recurrence. Dis Colon Rectum 49, 1136–1140 (2006). https://doi.org/10.1007/s10350-006-0616-0

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  • DOI: https://doi.org/10.1007/s10350-006-0616-0

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