Clinical and functional outcome of laparoscopic posterior rectopexy (Wells) for full-thickness rectal prolapse. A prospective study.
BACKGROUND
Laparoscopic rectopexy offers the advantages of the open transabdominal approach while decreasing the surgical comorbidity. The aim of this prospective study was to assess the clinical and functional outcome of laparoscopic Wells procedure for full-thickness rectal prolapse.


METHODS
Between 1999 and 2005, 77 patients underwent laparoscopic modified Wells procedure for full-thickness rectal prolapse. The patients were evaluated postoperatively for resolution of their prolapse and functional outcome, as well as for their satisfaction level regarding the procedure.


RESULTS
Laparoscopy was successful in all but one case. There were no major intra- or postoperative complications and the mean hospital stay was 4.9 days. Approximately half of the patients had some degree of fecal incontinence preoperatively. At long-term follow up, 89 percent experienced alleviation of symptoms. Constipation was improved in 36% of cases. Eighteen percent of the patients suffered a new onset of constipation. Recurrent prolapse was observed in one patient. Ninety percent of the patients were satisfied at long-term follow-up.


CONCLUSIONS
The laparoscopic Wells procedure for rectal prolapse had good functional results, a low recurrence rate and proved to be a feasible and safe procedure. Postoperative constipation remains a problem, which should be solved.
Dulucq
Jean-Louis
JL
Department of abdominal surgery, Maison de Santé Protestante, Bagatelle hospital, Route de Toulouse 203, 33401, Talence-Bordeaux, France. jld@ils-chirurgie.com
Wintringer
Pascal
P
Mahajna
Ahmad
A
D000368:Aged; D000369:Aged, 80 and over; D003248:Constipation / Q000209:etiology / Q000503:physiopathology; D005240:Feasibility Studies; D005242:Fecal Incontinence / Q000209:etiology / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011184:Postoperative Period; D011446:Prospective Studies; D012005:Rectal Prolapse / Q000150:complications / Q000503:physiopathology* / Q000601:surgery*; D012007:Rectum / Q000503:physiopathology*; D012008:Recurrence; D016896:Treatment Outcome