Laparoscopic Vaginal Suspension and Rectopexy for Rectal Prolapse
| Autor: | Jong-Kyun Lee, Shi-Jun Yang, Seo-Gue Yoon, Ki-Yun Lim |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Vaginal suspension Pelvic organ prolapse suspension Middle compartment prolapse 03 medical and health sciences 0302 clinical medicine Quality of life Female patient medicine Fecal incontinence Rectal prolapse Ventral rectopexy business.industry General surgery Medical record Gastroenterology Combined procedure medicine.disease 030220 oncology & carcinogenesis Defecation Original Article 030211 gastroenterology & hepatology Surgery medicine.symptom business |
| Zdroj: | Annals of Coloproctology |
| ISSN: | 2287-9722 2287-9714 |
| DOI: | 10.3393/ac.2017.33.2.64 |
| Popis: | Purpose Laparoscopic procedures for the treatment of patients with a rectal prolapse have gained increasing worldwide acceptance because they have lower recurrence and better functional outcome than perineal procedures. Nevertheless, ideal surgical methods are still not available. We propose a new surgical technique, laparoscopic vaginal suspension and rectopexy, for correcting a full-thickness rectal prolapse and/or middle-compartment prolapse. This study assessed the short-term outcomes for patients who underwent laparoscopic vaginal suspension and rectopexy. Methods Between April 2014 and April 2016, 69 female patients underwent laparoscopic vaginal suspension and rectopexy to correct a rectal prolapse. Demographics, medical histories, and surgical and follow-up details were collected from their medical records. In addition to the clinical outcome, we repeated defecation proctography and a questionnaire regarding functional results three months after surgery. Results No major morbidities or no mortalities occurred. The defecation proctography confirmed excellent anatomical result in all cases. Of 7 patients with combined middle-compartment prolapses, we observed good anatomical correction. During follow-up, full-thickness recurrence occurred in one patient. Preoperative fecal incontinence was improved significantly at 3 months (mean Wexner score: 12.35 vs. 7.71; mean FISI: 33.29 vs. 21.07; P < 0.001). Analysis of responses to the fecal incontinence quality of life (FIQOL) questionnaire showed overall improvement at 3 months compared to the preoperative baseline (mean pre- and postoperative FIQOL scores: 12.11 vs. 14.39; P < 0.004). Conclusion Laparoscopic vaginal suspension and rectopexy is a new combined procedure for the treatment of patients with rectal prolapses. It has excellent functional outcomes and minimal morbidity and can correct and prevent middlecompartment prolapses. |
| Databáze: | OpenAIRE |
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