title: Case-matched series of a non-cross-linked biologic versus non-absorbable mesh in laparoscopic ventral rectopexy.
abstract: OBJECTIVE
  Laparoscopic ventral mesh rectopexy (LVR) is an emerging technique for selected patients with rectal prolapse and obstructed defaecation syndrome. Data are insufficient to conclude which type of mesh affords the greatest benefit. Our aim was to compare the outcomes of LVR using a non-cross-linked biologic versus a permanent mesh.
  
  
  METHODS
  Twenty nine cases of LVR with permanent mesh were matched based on age and surgical indication with an equal number of patients using biologic mesh. Cases were retrospectively reviewed from a prospectively maintained database. Symptom resolution, patient satisfaction and recurrence of prolapse were measured among those who underwent LVR with either a biologic (Biodesign(®), Cook Medical) or polypropylene mesh.
  
  
  RESULTS
  Age, American Society of Anesthesiologists (ASA) class, surgical indication and primary symptoms were not different between the two groups. After a median follow-up of 15.4 months, all patients reported being either completely or partially satisfied. Rates of complete or partial symptom resolution (p = 0.26) or satisfaction (p = 0.27) did not differ between groups. After LVR, similar rates of additional procedures were performed in the biologic (21 %) and the permanent (28 %) mesh group. Among patients with full-thickness prolapse (n = 33), there were five cases (15 %) of recurrence, one in the biologic group and four in the permanent mesh group (p = 0.37). There were no mesh-related complications in either group.
  
  
  CONCLUSIONS
  LVR using a non-cross-linked biologic mesh appears to have comparable rates of symptom improvement and patient satisfaction in the short term. Longer follow-up will be required to determine if prolapse recurrence depends on mesh type.
authors.affiliation: Ferguson Clinic/Spectrum Health, Division of Colorectal Surgery, Grand Rapids Medical Education Partners/Michigan State University, Grand Rapids, MI, USA.
authors.forename: James W
authors.initials: JW
authors.lastname: Ogilvie
authors.forename: Andrew R L
authors.initials: AR
authors.lastname: Stevenson
authors.forename: Michael
authors.initials: M
authors.lastname: Powar
mesh_terms: D000368:Aged; D004867:Equipment Design; D005260:Female; D006801:Humans; D010535:Laparoscopy; D017060:Patient Satisfaction; D012005:Rectal Prolapse / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D013526:Surgical Mesh; D016896:Treatment Outcome