[Clinical and functional results of abdominal rectopexy using different fixation principles].
We report our results with abdominal rectopexy (modified Ripstein procedure, Ripstein/Corman) without resection of the colon in 63 patients using lyophylized dura-strips, Vicryl gauze or Dexon gauze, as the underlying fixation material for the mobilized rectum, presacral fascia and fixation suture material. Forty-five of 64 patients (71.4%) were reevaluated by proctoscopic examination and questioning; the mean follow-up time was 52.5 months (range 3-136 months). Postoperative mortality due to the method was 0%; the mortality was 1.6% (n = 1/63) in general for the first postoperative 30-day period as a result of cardiac complications. There were three complications (4.7%) the durating operation. Postoperative morbidity was 25.4% (16/63); infectious complications occurred in 12.7% (8/63) of cases, with one case of spontaneous closure of a pelvicutaneous fistula after intraoperative injury to the rectal wall. Full-thickness rectal prolapse appeared after rectopexy in 4.4% (2/45) (dura material alone) and mucosal prolapse was seen in 15.5% (7/45) of the follow-up group. Constipation was reduced by 28.6% (18/63) to 22.2% during the follow-up. Seventeen of 28 patients (60.7%) with incontinence showed an improvement; total continence was registered in 35.7% (10/28). The increase in continence as a result of abdominal rectopexy was significant (Wilcoxon, P = 0.05). The special aspects of being in an older age group, having a long history of procidentia, the number of deliveries, the length of the preoperative incontinence period all showed no influence on the postoperative degree of continence (Spearman's rank correlation). In 7/15 cases with persisting incontinence after rectopexy, postanal repair (Parks) was efficient in 7/7 cases leading to total or partial continence.(ABSTRACT TRUNCATED AT 250 WORDS)
Winde
G
G
Klinik und Poliklinik für Allgemeine Chirurgie, Westfälische Wilhelms-Universität, Münster.
Reers
B
B
Holzgreve
A
A
Fischer
R
R
Bohlmann
A
A
Bünte
H
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001557:Benzenesulfonates; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011098:Polyglactin 910; D011183:Postoperative Complications / Q000209:etiology*; D012005:Rectal Prolapse / Q000601:surgery*; D012008:Recurrence; D013526:Surgical Mesh; D013536:Suture Techniques
D001557:Benzenesulfonates; C007287:dexon (fungicide), sodium salt; D011098:Polyglactin 910
Klinische und funktionelle Ergebnisse der abdominalen Rektopexie unter Verwendung verschiedener Fixierungsgrundlagen.