Laparoscopic posterior mesh rectopexy for rectal prolapse is a safe procedure in older patients: A prospective follow-up study

Scand J Surg. 2015 Dec;104(4):227-32. doi: 10.1177/1457496914565418. Epub 2015 Jan 7.

Abstract

Background and aims: The aim of this study is to examine the clinical and functional outcome of laparoscopic posterior rectopexy in a consecutive series of adult patients with full-thickness rectal prolapse.

Material and methods: Preoperative data on demography, life-style practices, medication, comorbidity, and previous surgery for rectal prolapse were ascertained from patient charts. Information on operative procedure, and pre- and postoperative complications were recorded. Short- and long-term follow-up were done after a median of 60 days and 2 years after surgery.

Results: Between 1 February 2009 to 1 June 2012, 81 laparoscopic posterior rectopexies were done. Male-to-female ratio was 4:77, median age 73 [57-80.5] years and median ASA Grade 2. Conversion to open surgery was done in 6.2%, the median operating time was 82 min [66 - 102] and median length of hospital stay was 2 days [2-5.7]. Minor and major complications were seen in 5.3% and 14.8%, respectively. The 30-day mortality rate was 1.2%. Constipation or incontinence improved or disappeared in 65.2% and 74.4%, respectively. The cumulated recurrence rate was 11.1% after a median observation time of 2 years.

Conclusion: Laparoscopic posterior rectopexy is a safe and well-tolerated procedure in older patients and can be done with acceptable complications and recurrence rates and short hospital stays. Laparoscopic posterior rectopexy seems to improve bowel function in many patients.

Keywords: Prolapse; laparoscopy; obstipation; rectopexy; recurrence, incontinence.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Denmark / epidemiology
  • Fecal Incontinence / epidemiology
  • Fecal Incontinence / etiology*
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Laparoscopy / adverse effects
  • Laparoscopy / methods*
  • Male
  • Middle Aged
  • Plastic Surgery Procedures / adverse effects
  • Plastic Surgery Procedures / methods*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology*
  • Prospective Studies
  • Rectal Prolapse / surgery*
  • Rectum / surgery*
  • Surgical Mesh*
  • Time Factors
  • Treatment Outcome