Long-term results and functional outcome after Ripstein rectopexy.

Area of Science:

• Colorectal surgery
• Gastrointestinal surgery

Background:

• Rectal prolapse and internal rectal intussusception are conditions requiring surgical intervention.
• Ripstein rectopexy is a surgical technique used to address these conditions.

Purpose of the Study:

• To evaluate operative mortality, morbidity, and functional outcomes of Ripstein rectopexy.
• To assess the efficacy of the procedure for rectal prolapse and internal rectal intussusception.

Main Methods:

• A retrospective review of patient records was conducted.
• Sixty-nine patients with rectal prolapse and 43 with internal rectal intussusception were included.
• Long-term follow-up (median 7 years for prolapse, 5.4 for intussusception) involved clinical examination and standardized interviews.

Main Results:

• No operative mortality was observed.
• Operative morbidity was 33%, with minor complications predominating; severe early complications included bowel obstruction and ureteric stenosis.
• Late complications included rectovaginal fistulas and fecaloma; one patient had recurrent prolapse (1.6%).
• Incontinence improved (P=0.049), but bowel movement frequency decreased (P<0.001).
• Emptying difficulties increased in patients with internal rectal intussusception (P=0.038).

Conclusions:

• Ripstein rectopexy offers low mortality and recurrence rates for rectal prolapse and intussusception.
• A high rate of early complications and some serious late complications were noted.
• Functional outcomes include improved continence but a potential for increased constipation, particularly in internal rectal intussusception cases.