Results of Marlex mesh abdominal rectopexy for rectal prolapse in 100 consecutive patients

Keighley, M. R. B.; Fielding, J. W. L.; Alexander-Williams, J

doi:10.1002/bjs.1800700415

Cited by 149 publications

(54 citation statements)

References 11 publications

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“…Those procedures combining suspension-fixation with resection are associated with recurrence rates of 0 to 3.6% [2,8,14], while those without resection vary from 0 to 18.9% [2,7,14].…”

Section: Discussionmentioning

confidence: 99%

Surgical technique in prolapse of the rectum

Solla

Rothenberger

Goldberg

1989

Langenbecks Arch Chiv

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“…Those procedures combining suspension-fixation with resection are associated with recurrence rates of 0 to 3.6% [2,8,14], while those without resection vary from 0 to 18.9% [2,7,14].…”

Section: Discussionmentioning

confidence: 99%

Surgical technique in prolapse of the rectum

Solla

Rothenberger

Goldberg

1989

Langenbecks Arch Chiv

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“…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. There was an overall improvement in continence, with conflicting results in terms of constipation (Table 2).…”

Section: Prosthetic or Mesh Rectopexymentioning

confidence: 99%

Surgical Management of Rectal Prolapse

Madiba

Baig²,

Wexner³

2005

Arch Surg

298

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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“…Transabdominal procedures, however, usually imply rectal mobilization and fixation, colonic resection or a combination of both [23,24,25,26,27,28,29,30,31]. Functional results of transabdominal procedures such as mesh or suture rectopexy and resection-rectopexy show low recurrence rates, and continence is usually improved (Table 5, [2,27,28,30,32,32,33,34,35,36,37]).…”

Section: Rectal Prolapse: What Surgical Therapy Is Appropriate?mentioning

confidence: 99%

Rectal prolapse: which surgical option is appropriate?

Schiedeck¹,

Schwandner²,

Scheele³

et al. 2004

Langenbecks Arch Surg

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Numerous surgical procedures have been suggested to treat rectal prolapse. In elderly and high-risk patients, perineal approaches such as Delorme's procedure and perineal rectosigmoidectomy (Altemeier's procedure) have been preferred, although the incidence of recurrence and the rate of persistent incontinence seem to be high when compared with transabdominal procedures. Functional results of transabdominal procedures, including mesh or suture rectopexy and resection-rectopexy, are thought to be associated with low recurrence rates and improved continence. Transabdominal procedures, however, usually imply rectal mobilization and fixation, colonic resection, or both, and some concern is voiced that morbidity, in terms of infection or leakage, and mortality could be increased. If we focus on surgical outcome, our own experience of laparoscopic resection-rectopexy for rectal prolapse shows that the laparoscopic approach is safe and effective, and functional results with respect to recurrence are favorable. However, the controversy "which operation is appropriate?" cannot be answered definitely, as a clear definition of rectal prolapse, the extent of a standardized diagnostic assessment, and the type of surgical procedure have not been identified in published series. Randomized trials are needed to improve the evidence with which the optimal surgical treatment of rectal prolapse can be defined.

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Results of Marlex mesh abdominal rectopexy for rectal prolapse in 100 consecutive patients

Cited by 149 publications

References 11 publications

Surgical technique in prolapse of the rectum

Surgical technique in prolapse of the rectum

Surgical Management of Rectal Prolapse

Rectal prolapse: which surgical option is appropriate?

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