Bowel function after laparoscopic posterior sutured rectopexy versus ventral mesh rectopexy for rectal prolapse: a...

Area of Science:

• Colorectal Surgery
• Surgical Innovation
• Patient Outcomes

Background:

• Rectal prolapse management often involves surgical intervention.
• Laparoscopic ventral mesh rectopexy is a common procedure to address functional bowel disorders post-surgery.
• Comparing different surgical techniques is crucial for optimizing patient care.

Purpose of the Study:

• To compare functional outcomes 12 months after laparoscopic ventral mesh rectopexy versus laparoscopic posterior sutured rectopexy in rectal prolapse patients.
• To evaluate the change in obstructed defecation syndrome (ODS) score as the primary outcome.
• To assess the safety and complication rates of both procedures.

Main Methods:

• A double-blind, randomized trial involving adult patients with full-thickness rectal prolapse.
• Patients were assigned to either laparoscopic ventral mesh rectopexy or laparoscopic posterior sutured rectopexy.
• Functional outcomes, including ODS scores, were assessed preoperatively and 12 months postoperatively.

Main Results:

• No significant difference in the change of ODS score between the two surgical groups.
• Similar rates of serious postoperative complications (Clavien-Dindo grade II or worse) were observed in both groups.
• A trend towards higher recurrence rates in the posterior sutured rectopexy group within 12 months was noted, though not statistically significant.

Conclusions:

• Laparoscopic ventral mesh rectopexy is not demonstrably superior to laparoscopic posterior sutured rectopexy in improving functional outcomes for rectal prolapse.
• Long-term, large-scale, multicenter randomized trials are necessary to further evaluate these surgical approaches.