Result Evaluation between Laparoscopic Anterior and Posterior Mesh Rectopexy in Complete Rectal Prolapse

Abstract

Background: The prospectively and retrospective collected databases for identifying outcome in patients of 20 or more years of age with full thickness external rectal prolapse (ERP) treated by laparoscopic ventral rectopexy. Primary end-points were age, and mortality, morbidity, length of hospital stay and recurrence. Aim of the study: Evaluation of the comparative result between anterior and posterior mesh rectopexy and better method of rectopexy. Patient and methods Twenty-four adult patients with complete rectal prolapse underwent operative treatment for the prolapse between January 2016 and December 2018. The diagnosis of rectal prolapse was made clinically and confirmed by defecation proctography. Patients underwent pre-operative colonoscopy or flexible sigmoidoscopy to exclude organic disease. Data on gender, age, mortality, morbidity, length of stay and recurrence were prospectively collected on an institutionally approved electronic database. Non-parametric data were described as median and range, while parametric data were presented as average and standard deviation. Results: 24 patients of median age 38 (20-52 years old). Patients underwent laparoscopic ventral rectopexy. There was no mortality and 10 (13%) patients had complications. At a median follow up of 8 (2 – 12) months, two (3%) patients developed a recurrent full thickness prolapse. Conclusions: Abdominal procedures are generally better for young fit patients. The results of all abdominal procedures are comparable. Suture and mesh rectopexy are still popular with many surgeons. The choice depends on the surgeon’s experience and preference. Similarly, the procedure may be done through a laparoscope. Laparoscopic ventral or dorsal rectopexy is safe to treat full-thickness ERP. Morbidity, mortality, and hospital stay are comparable with published rates with a tenfold lower recurrence.