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Rectopexy is an ineffective treatment for obstructed defecation
W J Orrom1, D C Bartolo, R Miller
1Division of Colon and Rectal Surgery, University of Minnesota Hospital, Minneapolis.
Diseases of the Colon and Rectum
|January 1, 1991
Summary
Rectopexy surgery for obstructed defecation, often linked to rectal intussusception, showed poor long-term results in most patients. While initial symptom relief occurred, long-term follow-up revealed limited effectiveness for this condition.
Area of Science:
- Colorectal Surgery
- Gastroenterology
- Pelvic Floor Disorders
Background:
- Obstructed defecation symptoms are frequently attributed to rectal intussusception.
- Rectopexy has been a surgical approach for managing these symptoms.
Purpose of the Study:
- To evaluate the efficacy of rectopexy in treating obstructed defecation.
- To assess changes in anorectal function and pelvic support after rectopexy.
Main Methods:
- Seventeen patients with obstructed defecation underwent manometry and proctography before and after rectopexy.
- Surgical techniques included anterior and posterior rectal fixation or posterior fixation only.
- Clinical outcomes and functional parameters were assessed at initial and long-term follow-up.
Main Results:
- No significant postoperative changes were observed in maximum resting pressure, voluntary contraction, pelvic descent, or anorectal angle.
- While many patients experienced initial symptom improvement, only two showed long-term benefit after a mean follow-up of 30.8 months.
- Most patients had poor clinical results, with some reporting worsening symptoms like tenesmus and increased stool frequency.
Conclusions:
- Rectopexy appears to be an ineffective treatment for the majority of patients suffering from obstructive defecation.
- Long-term outcomes suggest limited benefit despite potential resolution of rectal intussusception.