Functional results after the Orr-Loygue transabdominal rectopexy for complete rectal prolapse.
OBJECTIVE
The aim of this study was to assess functional results after Orr-Loygue transabdominal rectopexy for complete rectal prolapse.


METHODS
Thirty-one consecutive patients operated on for complete rectal prolapse between 1995 and 1998 were evaluated preoperatively and postoperatively with regard to anal incontinence, constipation, evacuation difficulties, and overall satisfaction with a standardized questionnaire. Anal continence assessment was based on a clinical scoring system.


RESULTS
After a mean follow-up of 28 +/- 13 (range, 12-57) months, no prolapse recurred. Preoperative and postoperative rates of incontinence were 81 percent (25/31) and 55 percent (17/31), respectively (P < 0.03). Continence improved in 24 (96 percent) of the 25 patients who were incontinent before surgery. The mean incontinence score decreased from 11.7 +/- 7.8 preoperatively to 3.2 +/- 4.2 postoperatively (P < 0.001). The self-reported constipation rate was 61 percent (19/31) before surgery and 71 percent (22/31) after surgery (P = nonsignificant). Constipation appeared or worsened in 16 patients (52 percent), whereas it disappeared or improved in 8 (26 percent; P = nonsignificant). Evacuation difficulties increased significantly after surgery from 23 percent (7/31) to 61 percent (19/31; P < 0.003). Ninety-seven percent of patients reported good or very good satisfaction.


CONCLUSIONS
Transabdominal Orr-Loygue rectopexy resulted in improved continence and a high satisfaction level. Despite a significant postoperative increase in evacuation difficulties, only a 10 percent (nonsignificant) increase in the self-reported constipation rate was observed.
Douard
Richard
R
Department of Gastrointestinal Surgery, Saint-Antoine University Hospital (Assistance Publique-Hôpitaux de Paris) and Faculty of Medicine Paris VI, Paris, France.
Frileux
Pascal
P
Brunel
Martin
M
Attal
Emmanuel
E
Tiret
Emmanuel
E
Parc
Rolland
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003107:Colorectal Surgery / Q000379:methods*; D003248:Constipation / Q000453:epidemiology; D005242:Fecal Incontinence / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012005:Rectal Prolapse / Q000503:physiopathology / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome