title: Outcome analysis of elderly patients undergoing laparoscopic resection rectopexy for rectal prolapse.
abstract: OBJECTIVE
  For treatment of rectal prolapse, abdominal approaches are generally offered to younger patients, whereas perineal, less invasive procedures are considered more beneficial in the elderly. The aim of this study was to analyze whether laparoscopic resection rectopexy (LRR) is suitable for older patients.
  
  
  METHODS
  Patients who received LRR for rectal prolapse were selected from a prospective laparoscopic colorectal surgery database. Perioperative and long-term outcome were compared between patients <75 years old (group A) and ≥75 years old (group B).
  
  
  RESULTS
  Of 154 patients, 111 were in group A and 43 in group B. There was one conversion that occurred in group B. Overall mortality rate was 1.3% (n = 2). Both patients were in group B (group B, 4.7%; p = 0.079). Differences in major and minor complications between the groups were not significant. Rates of improvement for incontinence were 62.7% (group A) and 66.7% (group B; p = 0.716); for constipation, the rates were 78.9% (group A) and 73.3% (group B; p = 0.832). All recurrences occurred in group A (n = 10; overall, 10.3%; group A, 13%). After exclusion of patients who had previously received perineal prolapse surgery, recurrence rate was 3.3% overall (group A, 4.3%).
  
  
  CONCLUSIONS
  This study supports the benefits of LRR for rectal prolapse in elderly patients. Age per se is not a contraindication for LRR. Elderly patients encounter complications slightly more frequently (although not statistically significant) than younger patients. Therefore, a very careful patient selection in the elderly is of paramount importance. However, the long-term outcome does not seem to differ between younger and elderly patients.
authors.affiliation: Department of Surgery, University of Schleswig-Holstein Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany. tlaubert@googlemail.com
authors.forename: Tilman
authors.initials: T
authors.lastname: Laubert
authors.forename: Franz G
authors.initials: FG
authors.lastname: Bader
authors.forename: Markus
authors.initials: M
authors.lastname: Kleemann
authors.forename: Hamed
authors.initials: H
authors.lastname: Esnaashari
authors.forename: Ralf
authors.initials: R
authors.lastname: Bouchard
authors.forename: Philipp
authors.initials: P
authors.lastname: Hildebrand
authors.forename: Erik
authors.initials: E
authors.lastname: Schlöricke
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Bruch
authors.forename: Uwe J
authors.initials: UJ
authors.lastname: Roblick
mesh_terms: D000368:Aged; D003248:Constipation / Q000209:etiology; D003710:Demography; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005242:Fecal Incontinence / Q000209:etiology; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006760:Hospitalization; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012005:Rectal Prolapse / Q000401:mortality / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D016896:Treatment Outcome