Long-term outcome after laparoscopic and open surgery for rectal prolapse: a case-control study

Area of Science:

• Colorectal Surgery
• Minimally Invasive Procedures
• Surgical Outcomes

Background:

• Laparoscopic repair (LR) for rectal prolapse may offer faster recovery and reduced perioperative complications versus open repair (OR).
• Limited data exists on long-term recurrence and functional outcomes for LR in rectal prolapse treatment.

Purpose of the Study:

• To compare the long-term recurrence rates and functional outcomes of laparoscopic repair (LR) versus open repair (OR) for rectal prolapse.
• To evaluate patient satisfaction and functional results following both surgical techniques.

Main Methods:

• Prospective data collection for laparoscopic repair (LR) cases (December 1991-April 2004).
• Matching LR patients with open repair (OR) patients by age, gender, and procedure type.
• Exclusion of patients with prior complex abdominal surgery or BMI > 40.
• Telephone survey for recurrence, bowel habits, continence, and satisfaction.

Main Results:

• LR patients experienced shorter hospital stays (3.9 vs 6.0 days).
• Recurrence rates requiring surgery were 9.3% for LR and 4.7% for OR (p=0.39) over a mean 59-month follow-up.
• Postoperative constipation improved more in LR patients (74% vs 54%), while incontinence rates were similar (30% vs 33%).

Conclusions:

• Laparoscopic repair (LR) for rectal prolapse is associated with significantly shorter hospital stays compared to open repair (OR).
• Both functional outcomes, including bowel function and continence, and the rates of recurrent full-thickness rectal prolapse are comparable between LR and OR over a 5-year period.