Abdominal rectopexy for rectal prolapse: a comparison of techniques

Area of Science:

• Colorectal Surgery
• Gastroenterology

Background:

• Rectal prolapse affects continence, necessitating surgical intervention.
• Rectopexy aims to restore rectal anatomy and function.

Purpose of the Study:

• Compare different abdominal rectopexy techniques.
• Investigate mechanisms of continence restoration after rectopexy, including sphincter function, rectal morphology, and sensation.

Main Methods:

• Prospective study of 68 patients undergoing four types of rectopexy.
• Preoperative and postoperative assessments included manometry, radiology, and electrosensitivity measurements.

Main Results:

• All rectopexy methods controlled prolapse; continence improved in all groups except Ivalon.
• Improved continence correlated with enhanced resting pressure, particularly in resection and suture rectopexy groups.
• Sphincter resting tone improved in resection and suture groups, unlike prosthetic groups. Rectal sensation improved universally.

Conclusions:

• Rectopexy effectively improves continence in rectal prolapse patients.
• Procedures without prosthetic materials may offer superior continence outcomes.
• Sphincter recovery, specifically improved resting pressure, is the primary factor in achieving better continence post-rectopexy.