Laparoscopic resection rectopexy versus laparoscopic ventral rectopexy for complete rectal prolapse.

Area of Science:

• Colorectal surgery
• Minimally invasive procedures
• Pelvic floor disorders

Background:

• Laparoscopic resection rectopexy (LRR) and laparoscopic ventral rectopexy (LVR) are primary surgical options for rectal prolapse (RP).
• LRR is favored in the USA, while LVR is preferred in Europe.
• This study compares the efficacy and safety of LRR versus LVR for RP treatment.

Purpose of the Study:

• To compare laparoscopic resection rectopexy (LRR) and laparoscopic ventral rectopexy (LVR) in treating rectal prolapse (RP).
• To evaluate complications, functional outcomes, and recurrence rates between LRR and LVR.

Main Methods:

• Retrospective comparison of patients undergoing LRR at Cleveland Clinic Florida (2000-2012) and LVR at Meander Medical Center (2004-2012).
• Data collected included patient demographics, surgical technique, complications, functional results (constipation, incontinence), and recurrence.
• Statistical analysis was performed to compare outcomes between the two surgical groups.

Main Results:

• The LRR cohort included 28 female patients (mean age 50.1 years), and the LVR cohort included 40 patients (36 female, 4 male; mean age 67.0 years).
• Both LRR and LVR significantly reduced constipation and incontinence rates (P < 0.05).
• LRR had a significantly higher complication rate (9/28) compared to LVR (3/40) (P < 0.05), although continence showed a trend towards significance favoring LRR (P=0.09).

Conclusions:

• Both laparoscopic ventral rectopexy (LVR) and laparoscopic resection rectopexy (LRR) are effective treatments for rectal prolapse (RP).
• Both techniques significantly improve functional symptoms, including constipation and incontinence.
• While LRR may offer better continence, it is associated with a higher complication rate compared to LVR.