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A Comparison of Openvs.Laparoscopic Abdominal Rectopexy for Full-Thickness Rectal Prolapse: A Meta-Analysis

Purkayastha, Sanjay M.R.C.S.; Tekkis, Paris M.D., F.R.C.S.; Athanasiou, Thanos Ph.D., F.E.C.T.S.; Aziz, Omer M.R.C.S.; Paraskevas, Paraskeva Ph.D., F.R.C.S.; Ziprin, Paul M.D., F.R.C.S.; Darzi, Ara M.D., F.R.C.S., K.B.E.
Diseases of the Colon & Rectum: October 2005
doi: 10.1007/s10350-005-0077-x
Original Contribution: PDF Only

PURPOSE: PURPOSE:Using meta-analytical techniques, this study was designed to compare open and laparoscopic abdominal procedures used to treat full-thickness rectal prolapse in adults.

METHODS: METHODS:Comparative studies published between 1995 and 2003, cited in the literature of open abdominal rectopexyvs.laparoscopic abdominal rectopexy, were used. The primary end points were recurrence and morbidity, and the secondary end points assessed were operative time and length of hospital stay. A random effect model was used to aggregate the studies reporting these outcomes, and heterogeneity was assessed.

RESULTS: RESULTS:Six studies, consisting of a total of 195 patients (98 open and 97 laparoscopic) were included. Analysis of the data suggested that there is no significant difference in recurrence and morbidity between laparoscopic abdominal rectopexy and open abdominal rectopexy. Length of stay was significantly reduced in the laparoscopic group by 3.5 days (95 percent confidence interval, 3.1-4;P< 0.01), whereas the operative time was significantly longer in this group, by approximately 60 minutes (60.38 minutes; 95 percent confidence interval, 49-71.8).

CONCLUSIONS: CONCLUSIONS:Laparoscopic abdominal rectopexy is a safe and feasible procedure, which may compare equally with the open technique with regards to recurrence and morbidity and favorably with length of stay. However large-scale randomized trials, with comparative, sound methodology are still needed to ascertain detailed outcome measures accurately.

aDepartment of Surgical Oncology and Technology, 10th Floor QEQM Building, Praed Street, W2 1NY, London, United Kingdom, e-mail: p.tekkis@imperial.ac.uk

© The ASCRS 2005