Absorbable mesh in the treatment of rectal prolapse

Arndt, M.; Pircher, W

doi:10.1007/bf01648355

Cited by 24 publications

(12 citation statements)

References 7 publications

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“…These results have been reproduced by others. 35,[44][45][46] The mortality and recurrence rates are similar to figures reported after placement of nonabsorbable meshes.…”

Section: Prosthetic or Mesh Rectopexysupporting

confidence: 78%

“…10,16,22,29,31,34,38 Although the sponge rectopexy was popular before 1980, it has lost popularity and is confined to studies before 1994. Other nonabsorbable synthetic meshes have replaced the sponge, and more re- [35][36][37]44 have shown that the use of both absorbable and nonabsorbable meshes achieved similar results. The mortality rate was 0% to 1% and the recurrence rates were 0% to 6% for both absorbable [35][36][37] and nonabsorbable 7,10,13,32,34,37,38 meshes.…”

Section: Prosthetic or Mesh Rectopexymentioning

confidence: 91%

“…4,5,31,36,44,45,[47][48][49] Polyvinyl alcohol sponge placement carries an increased risk of infectious complications. 47,48 In 1996, Athanasiadis et al 45 performed posterior mesh rectopexy in 222 patients, with sigmoidectomy in 145.…”

Section: Prosthetic or Mesh Rectopexymentioning

confidence: 99%

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Surgical Management of Rectal Prolapse

Madiba

Baig²,

Wexner³

2005

Arch Surg

301

228

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Background:The problem of complete rectal prolapse is formidable, with no clear predominant treatment of choice. Surgical management is aimed at restoring physiology by correcting the prolapse and improving continence and constipation with acceptable mortality and recurrence rates. Abdominal procedures are ideal for young fit patients, whereas perineal procedures are reserved for older frail patients with significant comorbidity. Laparoscopic procedures with their advantages of early recovery, less pain, and possibly lower morbidity are recently added options. Regardless of the therapy chosen, matching the surgical selection to the patient is essential.Objective: To review the present status of the surgical treatment of rectal prolapse.Data Sources: Literature review using MEDLINE. All articles reporting on rectopexy were included.Study Selection: Articles reporting on prospective and retrospective comparisons were included. Case reports were excluded, as were studies comparing data with historical controls. Data Extraction:The results were tabulated to show outcomes of different studies and were compared. Studies that did not report some of the outcomes were noted as "not stated."Data Synthesis: Abdominal operations offer not only lower recurrence but also greater chance for functional improvements. Suture and mesh rectopexy produce equivalent results. However, the polyvinyl alcohol (Ivalon) sponge rectopexy is associated with an increased risk of infectious complications and has largely been abandoned. The advantage of adding a resection to the rectopexy seems to be related to less constipation. Laparoscopic rectopexy has similar results to open rectopexy but has all of the advantages related to laparoscopy. Perineal procedures are better suited to frail elderly patients with extensive comorbidity.Conclusions: Abdominal procedures are generally better for young fit patients; the results of all abdominal procedures are comparable. Suture and mesh rectopexy are still popular with many surgeons-the choice depends on the surgeon's experience and preference. Similarly, the procedure may be done through a laparoscope or by laparotomy. Perineal procedures are preferable for patients who are not fit for abdominal procedures, such as elderly frail patients with significant comorbidities. The decision between perineal rectosigmoidectomy and Delorme procedures will depend on the surgeon's preference, although the perineal rectosigmoidectomy has better outcomes.

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“…These results have been reproduced by others. 35,[44][45][46] The mortality and recurrence rates are similar to figures reported after placement of nonabsorbable meshes.…”

Section: Prosthetic or Mesh Rectopexysupporting

confidence: 78%

Section: Prosthetic or Mesh Rectopexymentioning

confidence: 91%

See 1 more Smart Citation

Surgical Management of Rectal Prolapse

Madiba

Baig²,

Wexner³

2005

Arch Surg

301

228

View full text Add to dashboard Cite

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“…In the studied group, recurrences were reported in 37,5% of the patients from 3 to 72 months after the operation (mean 37 months). Arndt and Pircher report recur-rence rate of 6% in the group of 62 patients, 36 to 45 months postoperatively (1).…”

Section: Discussionmentioning

confidence: 99%

“…The time of degradation of the polyglycolic acid or plygalactine meshes is of about 90 days, which is believed to be long enough for appropriate adhesion of the rectum to presacral fascia (1,11). Glycol acid release during degradation may also have bacteriostatic properties (6).…”

Section: Discussionmentioning

confidence: 99%

Abdominal Rectopexy with Absorbable and Non-Absorbable Materials in the Treatment for Rectal Prolapse

Kościński¹,

Meissner²,

Stadnik³

2011

Polish Journal of Surgery

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Kierownik: prof. dr hab. M. Drews the aim of the study was to present and compare own results of abdominal rectopexy performed with absorbable and nonabsorbable materials used in surgical repair of rectal prolapse. material and methods. In the years 1991-2009, 50 patients were operated on for rectal prolapse. The first 8 patients (group I) were operated using absorbale polyglycolic acid mesh. The next 42 patients were operated using non-absorbable polypropylene mesh (group II). 12 patients with chronic, incurable constipation had sigmoidectomy and rectopexy performed at the same operation. Rectopexy was performed with the mesh and fixed to the pelvic fascia and periosteum and mesorectum, leaving the anterior one third of the rectum free. 6 months after surgery functional outcomes were evaluated. Statistic analysis with the level of statistical significance p<0,005 was applied to obtained functional results. results. On the follow up visits, there were no symptoms of the recurrence of rectal prolapse in 5 patients (62.5%) from group I and in 25 patients (92.6%) from group II. Patients relapsing were reoperated 24 to 98 months after primary surgery. In all patients from group I (absorbable mesh), prosthetic material was not found at reoperation. In redo surgery only non-absorbable mesh was used. conclusions. The effectiveness of rectal fixation depends on the on the durability of the prosthetic material. In the studied group polypropylene mesh was superior in rectopexy to absorbable mesh.

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Abdominal rectopexy for rectal prolapse: a comparison of techniques

Duthie

Bartolo

1992

Journal of British Surgery

137

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To compare the methods of abdominal rectopexy and to elucidate the mechanism by which rectopexy restores continence in patients with rectal prolapse, the role of sphincter recovery, rectal morphological changes and improved rectal sensation were assessed in 68 patients (eight men, 60 women) of median age 63 (range 18-83) years undergoing resection rectopexy (n = 29), anterior and posterior Marlex rectopexy (n = 20), posterior Ivalon rectopexy (n = 9) or suture rectopexy (n = 10). Preoperative and postoperative manometry, radiology and electrosensitivity measurements were made. Age and duration of follow-up were similar in all groups and the prolapse was controlled in all patients. Significantly improved continence was seen in all but the Ivalon group. There was no evidence of increasing postoperative constipation. Sphincter length and voluntary contraction were unaltered, but improved resting tone was seen in the resection and suture groups. This was not seen in the prosthetic groups. Improved continence correlated with recovery of resting pressure. Upper and sensation was improved in all groups. Radiological changes did not correlate with improved continence. We conclude that continence is improved by all rectopexy procedures but seems better without prosthetic material. Sphincter recovery seems to be the most important factor.

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Absorbable mesh in the treatment of rectal prolapse

Cited by 24 publications

References 7 publications

Surgical Management of Rectal Prolapse

Surgical Management of Rectal Prolapse

Abdominal Rectopexy with Absorbable and Non-Absorbable Materials in the Treatment for Rectal Prolapse

Abdominal rectopexy for rectal prolapse: a comparison of techniques

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