Evaluation of Laparoscopic Ventral Mesh Rectopexy in Complete Rectal Prolapse
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- Category: Vol. 89, September 2021
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Evaluation of Laparoscopic Ventral Mesh Rectopexy in Complete Rectal Prolapse, AHMED M. NAFEI, YASSER M. ABDELSAMEE and MUSTAFA M. ABDO
Abstract
Background: Complete rectal prolapse is a condition that greatly impairs the quality of life. Treatment in adults is essentially surgical but the optimum method is still a chal-lenging clinical problem in colorectal surgery. The literature offers abundant publications and there have been turns and twists in the evolution of surgical techniques for treatment of this condition. Aim of Study: To evaluate the outcome of laparoscopic ventral mesh rectopexy as a procedure for repair of complete rectal prolapse in terms of recurrence rate and post-operative improvement of faecal incontinence and constipation. Periop-erative outcomes, improvement in bowel dysfunction or appearance of new complications were documented from the hospital records maintained prospectively. Patients and Methods: This was a retrospective cohort study conducted on 20 patients with complete rectal prolapse underwent laparoscopic ventral mesh rectopexy admitted from colo-rectal unit clinic of Ain Shams University hospital in the period from January 2017 to December 2018, were eval-uated in the present study. Results: Twenty patients 13 females (65%) and 7 males (35%) with median age of 47.7. Wexner constipation score improved significantly from the preoperative value of median (IQR) 6.5 (range, 2-19) to 6 (range, 2-12) (p-value <0.001). In patients presenting with faecal incontinence (FI), significant improvement in post-operative wexner (Cleveland clinic incontinence score) (CCIS) from median (IQR) 14.5 (range 0-20) to 0 (range, 0-16) (p-value <0.001). Three cases (15%) of complete rectal prolapse recurrence were reported within 18 months follow-up. Conclusion: Despite a multitude of existing operative techniques for correction of rectal prolapse, we believe that laparoscopic ventral mesh rectopexy has obtained good results in terms of functional outcome of the abdominal procedures with low recurrence rate and significant improvement in constipation and faecal incontinence, offering the advantages of anterolateral mobilization, mesh repair and of a laparoscopic approach compared to an open one.