Aim: Recently, laparoscopic techniques are widely used for treatment of rectal prolapse. Therefore, the present work aims to compare the results between laparoscopic ventral mesh rectopexy (LVMR) and laparoscopic posterior mesh rectopexy (LPMR) for patients suffering from rectal prolapse. Materials and methods: This prospective study included forty-four patients with rectal prolapse admitted and managed at the Assiut University Hospitals (Assiut, Egypt) in the period between November 2016 and 31 December 2020. They were divided into two groups (22 patients in each group). Operative parameters, complications, length of hospital stay, postoperative improvement of constipation and fecal incontinence, as well as recurrence were investigated. Clinical symptoms were followed up after surgery with the mean period of 23.73 ± 14.817 months. Results: In the presented study, the mean patient age was 42.43 ± 14.05 years. There were 14 males (6 in the LPMR group vs 8 in the LVMR group) and 30 females (16 for LPMR vs 14 for LVMR) without a significant difference in-between. Operative time was shorter in LPMR (114.09 ± 12.690 minutes) compared with LVMR (181.82 ± 15.395 minutes). No postoperative complications were observed in 81.82% of patients who underwent LPMR and 90.91% of patients who underwent LVMR. Patients who underwent LVMR showed no impotence. Wexner's constipation score was postoperatively lower in LVMR than in LPMR (6.71 ± 3.29 vs 10.78 ± 2.80; respectively) indicating the significant improvement of constipation in LVMR compared with LPMR. A significant improvement of the symptoms of obstructed defecation syndrome was observed in both groups (p-value = 0.0001). Gastrointestinal quality-of-life score was highly increased from 66.09 ± 9.59 to 114.23 ± 8.64 after LVMR. Conclusion: Our study proves that LVMR is superior to LPMR in prevention of impotence, improvement of constipation as well enhancement of the quality of life. Thus, LVMR offers a safer and more effective approach for patients of all ages.
Gosselink MP, Joshi H, Adusumilli S, et al. Laparoscopic ventral rectopexy for faecal incontinence: Equivalent benefit is seen in internal and external rectal prolapse. J Gastrointest Surg 2015;19(3):558–563. DOI: 10.1007/s11605-014-2696-9.
Dyrberg DL, Nordentoft T, Rosenstock S. Laparoscopic posterior mesh rectopexy for rectal prolapse is a safe procedure in older patients: A prospective follow-up study. Scand J Surg 2015;104(4):227–232. DOI: 10.1177/1457496914565418.
Formijne Jonkers HA, Maya A, Draaisma WA, et al. Laparoscopic resection rectopexy versus laparoscopic ventral rectopexy for complete rectal prolapse. Tech Coloproctol 2014;18(7):641–646. DOI: 10.1007/s10151-014-1122-3.
Reche F, Faucheron JL. Laparoscopic ventral rectopexy is the gold standard treatment for rectal prolapse. Tech Coloproctol 2015;19(10):565–566. DOI: 10.1007/s10151-015-1358-6.
Lundby L, Laurberg S. Laparoscopic ventral mesh rectopexy for obstructed defaecation syndrome: Time for a critical appraisal. Colorectal Dis 2015;17(2):102–103. DOI: 10.1111/codi.12830.
Badrek‐Al Amoudi AH, Greenslade GL, Dixon AR. How to deal with complications after laparoscopic ventral mesh rectopexy: Lessons learnt from a tertiary referral centre. Colorectal Dis 2013;15(6):707–712. DOI: 10.1111/codi.12164.
Mik M, Trzcinski R, Kujawski R, et al. Rectal prolapse in women—Outcomes of perineal and abdominal approaches. Indian J Surg 2015;77(3):1121–1125. DOI: 10.1007/s12262-014-1196-1.
Madbouly KM, Youssef M. Laparoscopic ventral rectopexy versus laparoscopic wells rectopexy for complete rectal prolapse: Long-term results. J Laparoendosc Adv Surg Tech A 2018;28(1):1–6. DOI: 10.1089/lap.2017.0012.
Boons P, Collinson R, Cunningham C, et al. Laparoscopic ventral rectopexy for external rectal prolapse improves constipation and avoids de novo constipation. Colorectal Dis 2010;12(6):526–532. DOI: 10.1111/j.1463-1318.2009.01859.x.
Collinson R, Wijffels N, Cunningham C, et al. Laparoscopic ventral rectopexy for internal rectal prolapse: Short‐term functional results. Colorectal Dis 2010;12(2):97–104. DOI: 10.1111/j.1463-1318.2009.02049.x.
Wahed S, Ahmad M, Mohiuddin K, et al. Short‐term results for laparoscopic ventral rectopexy using biological mesh for pelvic organ prolapse. Colorectal Dis 2012;14(10):1242–1247. DOI: 10.1111/j.1463-1318.2011.02921.x.
Franceschilli L, Varvaras D, Capuano I, et al. Laparoscopic ventral rectopexy using biologic mesh for the treatment of obstructed defaecation syndrome and/or faecal incontinence in patients with internal rectal prolapse: A critical appraisal of the first 100 cases. Tech Coloproctol 2015;19(4):209–219. DOI: 10.1007/s10151-014-1255-4.
Portier G, Kirzin S, Cabarrot P, et al. The effect of abdominal ventral rectopexy on faecal incontinence and constipation in patients with internal intra‐anal rectal intussusception. Colorectal Dis 2011;13(8):914–917. DOI: 10.1111/j.1463-1318.2010.02327.x.
Wong MTC, Abet E, Rigaud J, et al. Minimally invasive ventral mesh rectopexy for complex rectocoele: Impact on anorectal and sexual function. Colorectal Dis 2011;13(10):e320–e326. DOI: 10.1111/j.1463-1318.2011.02688.x.
Evans C, Ong E, Jones OM, et al. Laparoscopic ventral rectopexy is effective for solitary rectal ulcer syndrome when associated with rectal prolapse. Colorectal Dis 2014;16(3):O112–O116. DOI: 10.1111/codi.12502.
Samaranayake CB, Luo C, Plank AW, et al. Systematic review on ventral rectopexy for rectal prolapse and intussusception. Colorectal Dis 2010;12(6):504–512. DOI: 10.1111/j.1463-1318.2009.01934.x.
Owais AE, Sumrien H, Mabey K, et al. Laparoscopic ventral mesh rectopexy in male patients with internal or external rectal prolapse. Colorectal Dis 2014;16(12):995–1000. DOI: 10.1111/codi.12763.
Rakinic J, Lisa SP. Rectal prolapse. Medscape 2009. Available at: https://emedicine.medscape.com/article/2026460-overview. Accessed on: June 2, 2021.
Makineni H, Thejeswi P, Rai BKS. Evaluation of clinical outcomes after abdominal rectopexy and delorme's procedure for rectal prolapse: A prospective study. J Clin Diagn Res 2014;8(5):NC04–NC07. DOI: 10.7860/JCDR/2014/7787.4353.
Wu JM, Wells EC, Hundley AF, et al. Mesh erosion in abdominal sacral colpopexy with and without concomitant hysterectomy. Am J Obstet Gynecol 2006;194(5):1418–1422. DOI: 10.1016/j.ajog.2006.01.051.
Nazemi TM, Kobashi KC. Complications of grafts used in female pelvic floor reconstruction: Mesh erosion and extrusion. Indian J Urol 2007;23(2):153–160. DOI: 10.4103/0970-1591.32067.
Cadeddu F, Sileri P, Grande M, et al. Focus on abdominal rectopexy for full-thickness rectal prolapse: Meta-analysis of literature. Tech Coloproctol 2012;16(1):37–53. DOI: 10.1007/s10151-011-0798-x.
Laubert T, Kleemann M, Schorcht A, et al. Laparoscopic rese-ction rectopexy for rectal prolapse: A single-center study during 16 years. Surg Endosc 2010;24(10):2401–2406. DOI: 10.1007/s00464-010-0962-9.
Madiba TE, Baig MK, Wexner SD. Surgical management of rectal prolapse. Arch Surg 2005;140(1):63–73. DOI: 10.1001/archsurg.140.1.63.
Borie F, Bigourdan JM, Pissas MH, et al. Laparoscopic ventral rectopexy for the treatment of outlet obstruction associated with recto-anal intussusception and rectocele: A valid alternative to STARR procedure in patients with anal sphincter weakness. Clin Res Hepatol Gastroenterol 2014;38(4):528–534. DOI: 10.1016/j.clinre.2013.12.010.