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Author Spotlight: Advancing Pelvic Prolapse Treatment with a Non-Mesh Approach using Laparoscopic Pectopexy
Published on: October 25, 2024
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Changing approaches to rectal prolapse repair in the elderly
Vitaliy Poylin1, Rodney Bensley, Deborah Nagle
1Colon and Rectal Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA and Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA USA.
Gastroenterology Report
|April 25, 2014
Summary
The abdominal approach for rectal prolapse repair is safe and effective for patients over 70. Laparoscopic techniques have made this approach feasible in older adults, with manageable complication rates.
Area of Science:
- Colorectal surgery
- Surgical outcomes
- Geriatric surgery
Background:
- The abdominal approach for rectal prolapse historically favored younger patients due to higher complication risks.
- Advancements in laparoscopic surgery and increased life expectancy warrant re-evaluation of this approach in older populations.
Purpose of the Study:
- To assess the feasibility, safety, and effectiveness of the abdominal approach for rectal prolapse repair in patients aged 70 and older.
Main Methods:
- Retrospective review of 46 abdominal rectal prolapse repairs (laparoscopic or open) between 2005 and 2011.
- Comparison of outcomes between patients under 70 and those 70 and older.
Main Results:
- Seventeen (37%) repairs were in patients over 70 (average age 76).
- Laparoscopic approach use increased over time, particularly in older patients (69%).
- Older patients had longer hospital stays (3.8 vs 2.6 days) and higher rates of urinary tract infections and ileus, but similar readmission rates.
Conclusions:
- The abdominal approach for rectal prolapse is feasible and safe in patients over 70.
- Laparoscopic techniques have improved the applicability of abdominal repair in this demographic.
- While some complications are more frequent in older adults, the overall outcomes are acceptable.
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