Information is needed on long-term functional results, sequelas, and outcome predictors for laparoscopic ventral mesh rectopexy.
The purpose of this study was to evaluate long-term function postventral rectopexy in patients with external rectal prolapse or internal rectal prolapse in a large cohort and to identify the possible effects of patient-related factors and operative technical details on patient-reported outcomes.
This was a retrospective review with a cross-sectional questionnaire study.
Data were collated from prospectively collected registries in 2 university and 2 central hospitals in Finland.
All 508 consecutive patients treated with ventral rectopexy for external rectal prolapse or symptomatic internal rectal prolapse in 2005 to 2013 were included.
A questionnaire concerning disease-related symptoms and effect on quality of life was used.
Defecatory function measured by the Wexner score, the obstructive defecation score, and subjective symptom and quality-of-life evaluation using the visual analog scale were included. The effects of patient-related factors and operative technical details were assessed using multivariate analysis.
The questionnaire response rate was 70.7% (330/467 living patients) with a median follow-up time of 44 months. The mean Wexner scores were 7.0 (SD = 6.1) and 6.9 (SD = 5.6), and the mean obstructive defecation scores were 9.7 (SD = 7.6) and 12.3 (SD = 8.0) for patients presenting with external rectal prolapse and internal rectal prolapse. Subjective symptom relief was experienced by 76% and reported more often by patients with external rectal prolapse than with internal rectal prolapse (86% vs 68%; p < 0.001). Complications occurred in 11.4% of patients, and the recurrence rate for rectal prolapse was 7.1%.
This study was limited by its lack of preoperative functional data and suboptimal questionnaire response rate.
Ventral mesh rectopexy effectively treats posterior pelvic floor dysfunction with a low complication rate and an acceptable recurrence rate. Patients with external rectal prolapse benefit more from the operation than those with symptomatic internal rectal prolapse. See Video Abstract at http://links.lww.com/DCR/A479.
1 Division of Gastroenterology, Department of Surgery, Oulu University Hospital, Oulu, Finland
2 Centre of Surgical Research, Medical Research Centre, University of Oulu, Oulu, Finland
3 Department of Surgery, Keski-Suomi Central Hospital, Jyväskylä, Finland
4 Department of Surgery, Helsinki University Hospital, Helsinki, Finland
5 Department of Surgery, Päijät-Häme Central Hospital, Lahti, Finland
6 Department of Surgery, University of Turku, Turku, Finland
Funding/Support: This study received state funding provided to Oulu University, Finland.
Financial Disclosure: None reported.
Part of the results were presented at the national meeting of the Finnish Society of Surgery, Helsinki, Finland, November 16, 2016.
Correspondence: Johanna Mäkelä-Kaikkonen, M.D., Division of Gastroenterological Surgery, Department of Surgery, Oulu University Hospital, PL 21, 90029 OYS Oulu, Finland. E-mail: email@example.com