title: Laparoscopic ventral rectopexy in an elderly population with external rectal prolapse: clinical and anal manometric results.
abstract: OBJECTIVE
  We report the clinical and anal manometric results of elderly patients treated with laparoscopic ventral rectopexy (LVR) for full-thickness rectal prolapse.
  
  
  METHODS
  From March 2009 to June 2012, patients were consecutively included. A modified laparoscopic Orr-Loygue procedure with posterior mobilisation was used. The patients were evaluated preoperatively, 2 months postoperatively and after 1 year. We registered Wexner incontinence scores and laxative uses by a questionnaire and performed simple anal manometry.
  
  
  RESULTS
  A total of 46 patients underwent operation, all women. The median age was 83 years (range 34-99), median prolapse size was 8 cm (range 2-15), and 30 % had previous prolapse surgery. The median operative time was 135 min (range 90-215), and the median length of stay was 2 days (range 1-14). The 30-day morbidity rate was 15 %, and there were two (4 %) deaths within 30 days. There was a significant reduction in incontinence scores after 2 months and 1 year. The anal resting pressures improved from 10 cm H(2)O slightly to 16 cm H(2)O after 2 months, significantly, and still significant after 1 year at 13 cm H(2)O. There were no changes in the use of laxatives. The median follow-up time was 1.5 years (range 0.5-3), and there were two prolapse recurrences (4 %) in this period.
  
  
  CONCLUSIONS
  Laparoscopic ventral rectopexy with posterior mobilisation seems to be effective and relatively well tolerated, although not without mortality in elderly debilitated patients. It improves incontinence. With increased life-year expectance, these patients may benefit from a lower risk of recurrence compared with perineal procedures.
authors.affiliation: Digestive Disease Center, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, Denmark, ta_bjerke@hotmail.com.
authors.forename: Trine
authors.initials: T
authors.lastname: Bjerke
authors.forename: Tommie
authors.initials: T
authors.lastname: Mynster
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000503:physiopathology*; D005242:Fecal Incontinence / Q000209:etiology / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D054368:Laxatives / Q000627:therapeutic use; D008365:Manometry; D011183:Postoperative Complications; D011312:Pressure; D012005:Rectal Prolapse / Q000503:physiopathology* / Q000601:surgery*; D012008:Recurrence
chemical_list: D054368:Laxatives