Mäkelä-Kaikkonen, J., Rautio, T., Kairaluoma, M., Carpelan-Holmström, M., Kössi, J., Rautio, A., … Mäkelä, J. (2018). Does Ventral Rectopexy Improve Pelvic Floor Function in the Long Term? Diseases of the Colon & Rectum, 61(2), 230–238. https://doi.org/10.1097/dcr.0000000000000974
Does ventral rectopexy improve pelvic floor function in the long term?
|Author:||Mäkelä-Kaikkonen, Johanna1,2; Rautio, Tero1,2; Kairaluoma, Matti3;|
1Department of Surgery, Division of Gastroenterology, Oulu University Hospital, Finland
2University of Oulu, Centre of Surgical Research, Medical Research Centre
3Department of Surgery, Keski-Suomi Central Hospital, Jyväskylä, Finland
4Department of Surgery, Helsinki University Hospital, Helsinki, Finland
5Department of Surgery, Päijät-Häme Central Hospital, Lahti, Finland
6Department of Surgery, University of Turku, Finland
|Online Access:||PDF Full Text (PDF, 2 MB)|
|Persistent link:|| http://urn.fi/urn:nbn:fi-fe2019111237659
|Publish Date:|| 2019-11-12
Background: Information is needed on long-term functional results, sequelas, and outcome predictors for laparoscopic ventral mesh rectopexy.
Objective: The purpose of this study was to evaluate long-term function postventral rectopexy in patients with external rectal prolapse or internal rectal prolapse in a large cohort and to identify the possible effects of patient-related factors and operative technical details on patient-reported outcomes.
Design: This was a retrospective review with a cross-sectional questionnaire study.
Settings: Data were collated from prospectively collected registries in 2 university and 2 central hospitals in Finland.
Patients: All 508 consecutive patients treated with ventral rectopexy for external rectal prolapse or symptomatic internal rectal prolapse in 2005 to 2013 were included.
Interventions: A questionnaire concerning disease-related symptoms and effect on quality of life was used.
Main outcome measures: Defecatory function measured by the Wexner score, the obstructive defecation score, and subjective symptom and quality-of-life evaluation using the visual analog scale were included. The effects of patient-related factors and operative technical details were assessed using multivariate analysis.
Results: The questionnaire response rate was 70.7% (330/467 living patients) with a median follow-up time of 44 months. The mean Wexner scores were 7.0 (SD = 6.1) and 6.9 (SD = 5.6), and the mean obstructive defecation scores were 9.7 (SD = 7.6) and 12.3 (SD = 8.0) for patients presenting with external rectal prolapse and internal rectal prolapse. Subjective symptom relief was experienced by 76% and reported more often by patients with external rectal prolapse than with internal rectal prolapse (86% vs 68%; p < 0.001). Complications occurred in 11.4% of patients, and the recurrence rate for rectal prolapse was 7.1%.
Limitations: This study was limited by its lack of preoperative functional data and suboptimal questionnaire response rate.
Conclusions: Ventral mesh rectopexy effectively treats posterior pelvic floor dysfunction with a low complication rate and an acceptable recurrence rate. Patients with external rectal prolapse benefit more from the operation than those with symptomatic internal rectal prolapse. See Video Abstract at http://links.lww.com/DCR/A479.
Diseases of the colon & rectum
|Pages:||230 - 238|
|Type of Publication:||
A1 Journal article – refereed
|Field of Science:||
3126 Surgery, anesthesiology, intensive care, radiology
© The ASCRS 2017. This is an Accepted Manuscript that was published in Diseases of the Colon & Rectum. The Definitive Version of Record can be found online at: https://doi.org/10.1097/dcr.0000000000000974.