Does Ventral Rectopexy Improve Pelvic Floor Function in the Long Term?
Dis Colon Rectum
; 61(2): 230-238, 2018 Feb.
Article
en En
| MEDLINE
| ID: mdl-29337779
ABSTRACT
BACKGROUND:
Information is needed on long-term functional results, sequelas, and outcome predictors for laparoscopic ventral mesh rectopexy.OBJECTIVE:
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.DESIGN:
This was a retrospective review with a cross-sectional questionnaire study. SETTINGS Data were collated from prospectively collected registries in 2 university and 2 central hospitals in Finland. PATIENTS All 508 consecutive patients treated with ventral rectopexy for external rectal prolapse or symptomatic internal rectal prolapse in 2005 to 2013 were included.INTERVENTIONS:
A questionnaire concerning disease-related symptoms and effect on quality of life was used. MAIN OUTCOMEMEASURES:
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.RESULTS:
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%.LIMITATIONS:
This study was limited by its lack of preoperative functional data and suboptimal questionnaire response rate.CONCLUSIONS:
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.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Recto
/
Prolapso Rectal
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Laparoscopía
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Diafragma Pélvico
/
Procedimientos Quirúrgicos Robotizados
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspecto:
Patient_preference
Límite:
Aged
/
Aged80
/
Female
/
Humans
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Male
/
Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
Dis Colon Rectum
Año:
2018
Tipo del documento:
Article
País de afiliación:
Finlandia