Laparoscopic ventral rectopexy in an elderly population with external rectal prolapse: clinical and anal manometric results

Abstract

Laparoscopic ventral rectopexy with posterior mobilisation seems to be effective and relatively well tolerated, although not without mortality in elderly debilitated patients. It improves incontinence. With increased life-year expectance, these patients may benefit from a lower risk of recurrence compared with perineal procedures.

European Society of Coloproctology guidance on the use of mesh in the pelvis in colorectal surgery

“…There were 38 studies reporting the outcome of the use of mesh with rectopexy [13‐51] and one study reporting the outcome of resection suture rectopexy [45]. It was not possible to estimate the effect from pooled data in GRADE evidence due to lack of a comparator in all studies and one non‐mesh study with 0% recurrence.…”

“…There were 30 studies that reported the outcome of the use of mesh with rectopexy [6,7,8,11,12,13,14,15,16,17,18,19,20,22,25,26,27,30,32,33,34,35,36,38,41,43,48,49,50,51]. The pooled recurrence rate in the biological mesh group was 4.5% while that in the synthetic mesh group was 4.6%.…”

“…Twenty‐four studies reported whether the peritoneum was closed after rectopexy: two studies showed outcomes of not closing and closing the peritoneum [19,30]. Other studies reported outcomes following closure of the peritoneum [7,9,11,13,14,20,22,27,32,33,34,35,36,37,38,40,43,46,48,49,50,79].…”

“…There were 17 case series studies that reported on recurrence with techniques that divided the lateral ligaments (three studies: [32,36,51] or preserved the lateral ligaments (14 studies: [8,11,12,14,15,17,19,20,22,27,30,48,49,50]. The pooled results from the three studies showed recurrence to be 2% after division while those of the 17 studies with ligament preservation showed a recurrence of 3.4%.…”

Surgical Approaches for Rectal Prolapse and their Comparative Study

“…Most patients were satisfied with the operation, but there was no association seen between satisfaction and functional result. 30 A German study from 2012 studied the outcome of LRR in elderly patients (> 75 years). The complication rate was slightly increased compared to the younger population.…”