title: Functional results two years after laparoscopic rectopexy.
abstract: BACKGROUND
  Rectopexy is one of the accepted treatment options for full-thickness rectal prolapse, but the details of the technique remain controversial. This unit has adopted a laparoscopic approach as an alternative to open surgery, and has used three techniques: mesh, suture, and resection. This retrospective study compares the long-term outcome.
  
  
  METHODS
  From 1993 to 1995, 14 patients underwent a laparoscopic posterior mesh rectopexy. From 1996 to 1999, 34 patients underwent laparoscopic suture rectopexy with (n = 18) or without sigmoid resection (n = 16).
  
  
  RESULTS
  There was no postoperative mortality, and morbidity was similar in the three groups, ranging from 11 to 19%. The mean follow-up was 47, 24, and 20 months for mesh, suture, and resection rectopexy, respectively. During follow-up, 1 patient in each group developed mucosal prolapse. There was no difference between the three groups for incontinence rate, which improved in more than 75% of patients who had impaired continence preoperatively. Postoperative constipation was observed in 2 patients (11%) after resection rectopexy, in 10 (62%) after suture rectopexy (P < 0.01 versus resection), and in 9 (64%) after mesh rectopexy (P < 0.01 versus resection).
  
  
  CONCLUSIONS
  Our results show that the addition of sigmoid resection to laparoscopic rectopexy is safe and could contribute to reduce the risk of severe constipation after operation. Laparoscopic mesh rectopexy confers no advantage over the sutured technique, which we now use as our fixation method of choice.
authors.affiliation: Academic Surgical Unit, St. Mary' Hospital Medical School, Praed St., W2 1NY, London, England, UK.
authors.forename: S
authors.initials: S
authors.lastname: Benoist
authors.forename: N
authors.initials: N
authors.lastname: Taffinder
authors.forename: S
authors.initials: S
authors.lastname: Gould
authors.forename: A
authors.initials: A
authors.lastname: Chang
authors.forename: A
authors.initials: A
authors.lastname: Darzi
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012005:Rectal Prolapse / Q000601:surgery*; D012189:Retrospective Studies; D013526:Surgical Mesh; D013537:Sutures; D013997:Time Factors