Laparoscopic ventral rectopexy for internal rectal prolapse: short-term functional results
Article first published online: 26 SEP 2009
© 2010 The Authors. Journal Compilation © 2010 The Association of Coloproctology of Great Britain and Ireland
Volume 12, Issue 2, pages 97–104, February 2010
How to Cite
Collinson, R., Wijffels, N., Cunningham, C. and Lindsey, I. (2010), Laparoscopic ventral rectopexy for internal rectal prolapse: short-term functional results. Colorectal Disease, 12: 97–104. doi: 10.1111/j.1463-1318.2009.02049.x
- Issue published online: 19 JAN 2010
- Article first published online: 26 SEP 2009
- Received 24 April 2009; accepted 9 July 2009
- rectal intussusception;
- internal rectal prolapse;
- occult rectal prolapse;
Objective Over the last 15 years, posterior rectopexy, which causes rectal autonomic denervation, was discredited for internal rectal prolapse because of poor results. The condition became medical, managed largely by biofeedback. We aimed to audit the short-term functional results of autonomic nerve-sparing laparoscopic ventral rectopexy (LVR) for internal rectal prolapse.
Method Prospectively collected data on LVR for internal rectal prolapse were analysed. End-points were changes in bowel function (Wexner Constipation Score and Fecal Incontinence Severity Index) at 3 and 12 months. Analysis was performed using Mann–Whitney U-test for unpaired data and Wilcoxon signed rank test for paired data (two-sided p-test). Functional outcomes were compared with those achieved previously for external rectal prolapse (ERP).
Results Seventy-five patients underwent LVR (median age 58, range 25–88 years, median follow up was 12 months). Mortality (0%), major (0%) and minor morbidity (4%) were acceptably low. Median length of stay was 2 days. Preoperative constipation (median Wexner score 12) and faecal incontinence (median FISI score 28) improved significantly at 3 months (Wexner 4, FISI 8, both P < 0.0001) and 12 months (Wexner 5, FISI 8, both P < 0.0001). No patient had worse function. Functional outcomes were similar to those for ERP.
Conclusion Laparoscopic ventral rectopexy for internal rectal prolapse improves symptoms of obstructed defaecation and faecal incontinence in the short-term. This establishes proof of concept for a nerve-sparing surgical treatment for internal rectal prolapse.