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Colonic transit before and after resection rectopexy for full-thickness rectal prolapse
M S El Muhtaseb1, D C C Bartolo, D Zayiae
1Department of Colorectal Surgery, Western General Hospital, Edinburgh, UK, muhtaseb11@hotmail.com.
Techniques in Coloproctology
|August 6, 2013
Summary
Resection rectopexy does not improve colonic transit time in most patients with complete rectal prolapse. This suggests underlying motility disorders are not addressed by this surgery, questioning its use.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Surgical Innovation
Background:
- Complete rectal prolapse affects colonic function.
- Resection rectopexy is a surgical treatment for rectal prolapse.
- Colonic transit time is a key indicator of bowel function.
Purpose of the Study:
- To evaluate the impact of resection rectopexy on colonic transit time.
- To assess changes in colonic motility after surgical intervention for rectal prolapse.
Main Methods:
- Prospective study involving 38 patients with complete rectal prolapse.
- Isotope colonic transit studies performed preoperatively and at least one year postoperatively.
- Comparison of colonic transit times before and after resection rectopexy.
Main Results:
- 70% of patients had prolonged colonic transit preoperatively.
- Resection rectopexy failed to correct delayed transit in all patients with abnormal preoperative tests.
- Four patients developed new transit delays, and two with normal transit remained unchanged post-surgery.
Conclusions:
- Most rectal prolapse patients exhibit pan-colonic motility disorders.
- Resection rectopexy does not resolve these underlying motility issues.
- Less invasive procedures like ventral rectopexy may be more appropriate for selected patients.
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