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Laparoscopic ventral mesh rectopexy (LVMR) for internal and external rectal prolapse: an analysis of 122 consecutive patients

Authors
Shin, Jae WonHong, Kwang DaeLee, Doo HanKim, Do SunLee, Doo Seok
Issue Date
Aug-2021
Publisher
Lippincott Williams & Wilkins Ltd.
Keywords
laparoscopy; rectal prolapse; constipation; fecal incontinence; ventral rectopexy; retrospective study
Citation
Surgical Laparoscopy, Endoscopy and Percutaneous Techniques, v.31, no.4, pp 479 - 484
Pages
6
Indexed
SCIE
SCOPUS
Journal Title
Surgical Laparoscopy, Endoscopy and Percutaneous Techniques
Volume
31
Number
4
Start Page
479
End Page
484
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/33684
DOI
10.1097/SLE.0000000000000905
ISSN
1530-4515
1534-4908
Abstract
Background: Even though several reports have been published on the results of laparoscopic ventral mesh rectopexy (LVMR) in Asia, there are few mid-term or long-term results of LVMR. The authors aimed to evaluate the results of LVMR in patients with internal rectal prolapse (IRP) external rectal prolapse (ERP). Materials and Methods: From September 2013 to January 2019, 122 patients with IRP (n=48) or ERP (n=74) underwent LVMR. Constipation and fecal incontinence (FI) scores were evaluated using the Cleveland Clinic Florida score preoperatively and postoperatively. The questionnaire for the change of obstructed defecation or FI symptoms after surgery was also administered to grade the results as cured, improved, unchanged, or worsened for each survey. Results: The mean age of the patients was 61.9 years. The mean operation time was 116.5 minutes, and the mean hospital stay was 5.1 days. The mean follow-up was 42.1 months. There were no mesh-related complications. Eight patients (10.7%) among the ERP group required additional surgery for recurrent full-thickness prolapse. Eleven patients (14.7%) who had mucosal prolapse within 2 cm underwent stapled hemorrhoidopexy after LVMR. In the postoperative 6-month period, the overall constipation score (7.12) significantly improved compared with the preoperative score (13.03) (P<0.001), whereas the FI score significantly improved after surgery (12.16 to 8.92; P<0.001). Conclusion: LVMR is a feasible and safe technique and favorable recurrence for ERP. Functional outcomes of obstructed defecation and FI were improved and the satisfaction of LVMR was high after the surgery. LVMR can be considered a recommended surgical option to treat ERP and IRP.
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Hong, Kwang Dae
Ansan Hospital (Department of Colon and Rectal Surgery, Ansan Hospital)
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