Citation Information :
Sayed MM, Reyad HA, Korany M, Abdelaal IM. Comparison between Laparoscopic Ventral and Posterior Mesh Rectopexy for Rectal Prolapse. World J Lap Surg 2022; 15 (3):239-245.
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.
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