University of Oulu

Laitakari, K.E., Mäkelä‐Kaikkonen, J.K., Pääkkö, E., Kata, I., Ohtonen, P., Mäkelä, J. and Rautio, T.T. (2020), Restored pelvic anatomy is preserved after laparoscopic and robot‐assisted ventral rectopexy: MRI‐based 5‐year follow‐up of a randomized controlled trial. Colorectal Dis, 22: 1667-1676. https://doi.org/10.1111/codi.15195

Restored pelvic anatomy is preserved after laparoscopic and robot‐assisted ventral rectopexy : MRI‐based 5‐year follow‐up of a randomized controlled trial

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Author: Laitakari, K. E.1,2; Mäkelä-Kaikkonen, J. K.1,2; Pääkkö, E.3;
Organizations: 1Department of Surgery, Division of Gastroenterology, Oulu University Hospital, Oulu, Finland
2Medical Research Center Oulu, Center of Surgical Research, University of Oulu, Oulu, Finland
3Department of Radiology, Oulu University Hospital, Oulu, Finland
4Division of Operative Care, Oulu University Hospital, Oulu, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.6 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe202102013358
Language: English
Published: John Wiley & Sons, 2020
Publish Date: 2021-06-16
Description:

Abstract

Aim: Our aim was to compare the long‐term anatomical outcomes between robot‐assisted ventral mesh rectopexy (RVMR) and laparoscopic ventral mesh rectopexy (LVMR) for external or internal rectal prolapse.

Method: This study is a follow‐up of a single‐centre randomized controlled trial (RCT). Thirty patients were randomly allocated to RVMR (n = 16) or LVMR (n = 14). The primary end‐point was maintenance of the restored pelvic anatomy 5 years after the operation, as assessed by magnetic resonance (MR) defaecography. Secondary outcome measures included the Pelvic Organ Prolapse Quantification (POP‐Q) measures and functional results assessed using symptom questionnaires.

Results: Twenty‐six patients (14 RVMR and 12 LVMR) completed the 5‐year follow‐up and were included in the study. The MRI results, POP‐Q measurements and symptom‐specific quality of life measures did not differ between the RVMR and LVMR groups. The MRI measurements of the total study population remained unchanged between 3 months and 5 years. In the Pelvic Floor Distress Inventory (PFDI‐20), the RVMR group had lower symptom scores (mean 96.0, SD 70.7) than the LVMR group (mean 160.6, SD 58.9; P = 0.004). In the subscales of pelvic organ prolapse (POPDI‐6) (mean 23.2, SD 24.3 vs mean 52.4, SD 22.4; P = 0.001) and the Colorectal–Anal Distress Inventory (CRADI‐8) (mean 38.4, SD 23.3 vs mean 58.6, SD 25.4; P = 0.009), the patients in the RVMR group had significantly better outcomes.

Conclusions: After VMR, the corrected anatomy was preserved. There were no clinically significant differences in anatomical results between the RVMR and LVMR procedures 5 years after surgery based on MR defaecography. However, functional outcomes were better after RMVR.

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Series: Colorectal disease
ISSN: 1462-8910
ISSN-E: 1463-1318
ISSN-L: 1462-8910
Volume: 22
Issue: 11
DOI: 10.1111/codi.15195
OADOI: https://oadoi.org/10.1111/codi.15195
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
Subjects:
Funding: State research funding.
Copyright information: Colorectal Disease © 2020 The Association of Coloproctology of Great Britain and Ireland. This is the peer reviewed version of the following article: Laitakari, K.E., Mäkelä‐Kaikkonen, J.K., Pääkkö, E., Kata, I., Ohtonen, P., Mäkelä, J. and Rautio, T.T. (2020), Restored pelvic anatomy is preserved after laparoscopic and robot‐assisted ventral rectopexy: MRI‐based 5‐year follow‐up of a randomized controlled trial. Colorectal Dis, 22: 1667-1676, which has been published in final form at https://doi.org/10.1111/codi.15195. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.