Very long-term outcome after resection rectopexy for internal rectal intussusception

Abstract

Background Both at short- and long-term follow-up we have reported major improvement of the symptom of constipation in patients treated with resection rectopexy for internal rectal intussusception (IRI). The aim was to study whether this improvement also persisted in a cohort of these patients after very long-term follow-up. Methods Observational and mainly prospective study of a cohort of 13 out of 48 patients with IRI who initially had ligament-preserving resection rectopexy with suture by laparoscopic (n = 11) or open (n = 2) technique. Outcome measures were morbidity, scores for constipation and anal incontinence, patients’ report and HRQL. Results Thirteen out of the 48 initial patients (27%) reported data at very long-term follow-up. Months from preoperatively to short-, long- and very long-term follow-up were median 6, 76 and 159, respectively. Corresponding mean (95% CI) constipation scores were 11.5 (8.3–14.7), 4.2 (1.7–6.6) (p < .001), 5.3 (3.6–7.0) (p < .05) and 13.6 (8.2–19.0). Number of constipated patients were (score ≥ 10) were 8, 1, 0, 1 and 9, respectively. Scores for anal incontinence were 6.1 (2.4–11.4), 5.8 (2.0–9.5), 4.9 (0.9–9.0) and 7.9 (4.3–11.5), respectively. HRQL life was reduced for bodily pain, social functioning, mental health and general health perception. Percentage patients reporting symptomatic improvement were 100, 70 and 53, respectively. Conclusions Patients with IRI have a symptomatic relief for more than 6 years after resection rectopexy. The operation did not inflict permanent patient sequela. Motivated patients must be informed about very long-term deterioration of symptomatic relief.