Laparoscopically-assisted resection rectopexy for rectal prolapse: Ten years' experience

Ashari, L. H. S., Lumley, J. W., Stevenson, A. R. L. and Stitz, R. W. (2005) Laparoscopically-assisted resection rectopexy for rectal prolapse: Ten years' experience. Diseases of The Colon & Rectum, 48 5: 982-987. doi:10.1007/s10350-004-0886-3

Author Ashari, L. H. S.
Lumley, J. W.
Stevenson, A. R. L.
Stitz, R. W.
Title Laparoscopically-assisted resection rectopexy for rectal prolapse: Ten years' experience
Journal name Diseases of The Colon & Rectum   Check publisher's open access policy
ISSN 0012-3706
Publication date 2005-05
Sub-type Article (original research)
DOI 10.1007/s10350-004-0886-3
Volume 48
Issue 5
Start page 982
End page 987
Total pages 6
Place of publication New York
Publisher Springer
Collection year 2005
Language eng
Subject C1
1103 Clinical Sciences
Abstract PURPOSE: This study has been undertaken to audit a single-center experience with laparoscopically-assisted resection rectopexy for full-thickness rectal prolapse. The clinical Outcomes and long-term results were evaluated. METHODS: The data were prospectively collected for the duration of the operation, time to passage of flatus postoperatively, hospital stay, morbidity, and mortality. For follow-up, patients received a questionnaire or were contacted. The data were divided into quartiles over the study period, and the differences in operating time and length of hospital stay were tested using the Kruskal-Wallis test. RESULTS: Between March 1992 and October 2003, a total of 117 patients underwent laparoscopic resection rectopexy for rectal prolapse. The median operating time during the first quartile (representing the early experience) was 180 minutes compared with 110 minutes for the fourth quartile (Kruskal-Wallis test for operating time = 35.523, 3 df, P < 0.0001). Overall morbidity was 9 percent (ten patients), with one death (< 1 percent). One patient had a ureteric injury requiring conversion. One minor anastomotic leak Occurred, necessitating laparoscopic evacuation of a pelvic abscess. Altogether, 77 patients were available for follow-up. The median follow-up was 62 months. Eighty percent of the patients reported alleviation of their symptoms after the operation. Sixty-nine percent of the constipated patients experienced an improvement in bowel frequency. No patient had new or worsening symptoms of constipation after Surgery. Two (2.5 percent) patients had full-thickness rectal prolapse recurrence. Mucosal prolapse recurred in 14 (18 percent) patients. Anastomotic dilation was performed for stricture in five (4 percent) patients. CONCLUSIONS: Laparoscopically-assisted resection rectopexy for rectal prolapse provides a favorable functional outcome and low recurrence rate. Shorter operating time is achieved with experience. The minimally invasive technique benefits should be considered when offering rectal prolapse patients a transabdominal approach for repair, and emphasis should now be on advanced training in the laparoscopic approach.
Keyword Prolapse
Resection Rectopexy
Gastroenterology & Hepatology
Abdominal Rectopexy
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2006 Higher Education Research Data Collection
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 34 times in Thomson Reuters Web of Science Article | Citations
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Created: Wed, 15 Aug 2007, 06:14:03 EST