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Laparoscopic‐assisted resection‐rectopexy for rectal prolapseEarly and medium follow‐up

 

作者: Andrew R. Stevenson,   Russell Stitz,   John Lumley,  

 

期刊: Diseases of the Colon & Rectum  (OVID Available online 1998)
卷期: Volume 41, issue 1  

页码: 46-54

 

ISSN:0012-3706

 

年代: 1998

 

出版商: OVID

 

关键词: Prolapse;Incontinence;Laparoscopy;Resection rectopexy;Rectopexy

 

数据来源: OVID

 

摘要:

PURPOSE:Objectives of this study were to describe the technique of laparoscopic‐assisted resection rectopexy and audit the clinical outcomes, including review of functional results.METHODS:Data were prospectively collected for duration of operation, time to passage of flatus and feces postoperatively, hospital stay, morbidity, and mortality. Follow‐up was performed by an independent assessor using a standardized questionnaire. Patients were also assessed by clinical review or telephone interview.RESULTS:During a four‐year period, 34 patients underwent laparoscopic repair for rectal prolapse, of which 30 patients underwent laparoscopic‐assisted resection rectopexy. Median duration of the operations was 185 minutes, median time for passage of flatus was two days postoperatively, and median length of hospital stay was five days. Morbidity was 13 percent and mortality rate was 3 percent. Comparison between the first ten patients who underwent laparoscopic‐assisted resection rectopexy and the last ten revealed a significant reduction in both median duration of operating time (224vs.163 minutes;P<0.005) and length of stay (6vs.4 days;P<0.015). Follow‐up study conducted at a median time of 18 months revealed that most patients (92 percent) felt that the operation had improved their symptoms, that incontinence was improved in 14 of 20 patients with impaired continence (70 percent), and that constipation was improved in 64 percent. Symptoms of incomplete emptying and the need to strain at stool were both improved in 62 and 59 percent of patients, respectively. No full‐thickness recurrences have occurred, but two patients have had mucosal prolapse detected (7 percent) and treated.CONCLUSION:Laparoscopic‐assisted resection rectopexy is feasible and safe, with acceptable recurrence rates and functional results compared with the open procedure in the surgical literature. There is rapid return of intestinal function associated with an early discharge from hospital.

 

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