Laparoscopic rectopexy for complete rectal prolapse. Clinical outcome and anorectal function tests.
BACKGROUND
The purpose of this study was to evaluate the clinical outcome of laparoscopic rectopexy and its effect on anorectal function investigations.


METHODS
Twelve patients with complete rectal prolapse without constipation underwent laparoscopic rectopexy. Pre- and postoperative evaluation included scoring of incontinence, anorectal manometry, and anal endosonography.


RESULTS
No recurrences of rectal prolapse were seen (median follow-up 19 months). Continence improved in eight of nine preoperatively incontinent patients. Two patients had mild constipation after surgery. Median maximum basal pressure measured by anorectal manometry increased from 20 to 25 mmHg (p = 0.005) and the rectoanal inhibitory reflex improved in seven patients (p = 0.03). Rectal sensitivity did not change significantly. Endosonography showed asymmetry and thickening of the internal anal sphincter and submucosa preoperatively. After surgery the maximum internal anal sphincter thickness decreased from 3.0 mm to 2.6 mm (p = 0.02).


CONCLUSIONS
Laparoscopic rectopexy improved continence in our patients. Anorectal function tests show a partial recovery of the internal anal sphincter. Laparoscopic rectopexy combines the low morbidity of minimal invasive surgery with the good outcome of abdominal rectopexy.
Poen
A C
AC
Department of General Surgery, University Hospital, Vrije Universiteit, Amsterdam, The Netherlands.
de Brauw
M
M
Felt-Bersma
R J
RJ
de Jong
D
D
Cuesta
M A
MA
D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000000981:diagnostic imaging; D019160:Endosonography; D005242:Fecal Incontinence / Q000209:etiology / Q000601:surgery; D006801:Humans; D010535:Laparoscopy; D008365:Manometry; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D012005:Rectal Prolapse / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*