Ten-year follow up after laparoscopic suture rectopexy for full-thickness rectal prolapse

Area of Science:

• Colorectal surgery
• Minimally invasive surgery
• Pelvic floor disorders

Background:

• Full-thickness rectal prolapse (FTRP) has high recurrence rates after surgery.
• Long-term outcomes of laparoscopic suture rectopexy for FTRP require further evaluation.

Purpose of the Study:

• To assess the 10-year recurrence rates of laparoscopic suture rectopexy for FTRP.
• To evaluate the long-term functional outcomes, including continence and quality of life, after this procedure.

Main Methods:

• Prospective analysis of patients undergoing laparoscopic suture rectopexy for FTRP (1993-2006).
• Procedure involved rectal mobilization and suture suspension to the sacral promontory.
• Exclusion of patients with pre-existing constipation or those unfit for anesthesia.
• Assessment of continence, quality of life, and constipation using validated scores.
• Kaplan-Meier method used for recurrence-free survival analysis.

Main Results:

• 179 patients (174 female, median age 62) underwent the procedure with no mortality.
• 4% 30-day complication rate observed.
• 10-year actuarial recurrence rate for FTRP was 20%.
• Significant improvements in continence (P < 0.0001) and quality of life (P < 0.001) were reported.
• Constipation levels remained unchanged postoperatively.

Conclusions:

• Laparoscopic suture rectopexy is associated with a 20% recurrence rate at 10 years for FTRP.
• The procedure offers significant long-term benefits in improved continence and quality of life.
• It is a safe procedure with a low complication rate and does not exacerbate constipation.