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Functional results after posterior abdominal rectopexy for rectal prolapse
K Yoshioka1, F Heyen, M R Keighley
1Department of Surgery, General Hospital, Birmingham, United Kingdom.
Diseases of the Colon and Rectum
|October 1, 1989
Summary
Abdominal rectopexy with Marlex mesh effectively treats rectal prolapse, significantly reducing incontinence. However, nearly half of patients experience new or persistent constipation post-surgery.
Area of Science:
- Colorectal Surgery
- Surgical Innovation
- Gastroenterology
Background:
- Rectal prolapse is a debilitating condition requiring surgical intervention.
- Abdominal rectopexy is a common surgical approach for rectal prolapse.
- The use of synthetic mesh, such as Marlex, aims to improve surgical outcomes.
Purpose of the Study:
- To evaluate the efficacy and safety of abdominal rectopexy using polypropylene (Marlex) mesh for rectal prolapse.
- To assess the impact of this procedure on fecal incontinence and constipation.
- To determine the recurrence rates of rectal prolapse after mesh-augmented rectopexy.
Main Methods:
- Retrospective review of 165 cases of abdominal rectopexy with Marlex mesh.
- Analysis of pre- and post-operative patient data, including incontinence and constipation status.
- Assessment of surgical outcomes, complications, and prolapse recurrence.
Main Results:
- Significant reduction in fecal incontinence from 58% pre-surgery to 16% post-surgery.
- Increased incidence of constipation, rising from 24% pre-surgery to 44% post-surgery.
- Low recurrence rate for full-thickness rectal prolapse (1.5%) and low incidence of mucosal prolapse (7%).
Conclusions:
- Abdominal posterior rectopexy with Marlex mesh is an effective surgical option for rectal prolapse.
- While effective in treating prolapse and reducing incontinence, the procedure is associated with a high rate of post-operative constipation.
- Further investigation into managing post-rectopexy constipation is warranted.