title: Safety of laparoscopic ventral rectopexy in the elderly: results from a nationwide database.
abstract: BACKGROUND
  Laparoscopic ventral rectopexy is an established procedure in the treatment of posterior pelvic organ prolapse. It is still unclear whether this procedure can be performed safely in the elderly.
  
  
  OBJECTIVE
  This study aimed to assess the effects of age on the outcome of laparoscopic ventral rectopexy performed for patients with pelvic organ prolapse.
  
  
  METHODS
  This study was a retrospective cohort analysis with data from a national registry.
  
  
  METHODS
  The study was conducted in a tertiary care setting.
  
  
  METHODS
  Patients undergoing laparoscopic ventral rectopexy were identified from discharge summaries. Patients were stratified according to age, including patients <70 (group A) and ≥ 70 (group B) years old.
  
  
  METHODS
  Variables analyzed included sex, age, diagnosis, associated pelvic organ prolapse, comorbidities, length of stay, complications (Clavien-Dindo scale), and mortality.
  
  
  RESULTS
  Among 4303 patients (98.2% women) who underwent a laparoscopic ventral rectopexy, 1263 (29.4%) were >70 years old (mean age, 76.2 ± 5.0 years). Main diagnoses were vaginal vault prolapse (53.0% [group A] vs 47.0% [group B]; p value not significant) and rectal prolapse (17.7 vs 26.8%; p value not significant). Comorbidity was significantly increased in group B (mean length of stay, 5.6 ± 3.6 vs 4.7 ± 1.8 days; p < 0.001) and minor complications (8.4% vs 5.0%; p < 0.001) were significantly increased in group B, whereas major complications were not different (group A, 0.7%; group B, 0.9%; p = 0.40) after univariate analysis. Multivariate analysis found no significant differences between groups. The subgroup analysis of patients >80 years old (n = 299) showed no differences. Each group had 1 postoperative mortality.
  
  
  CONCLUSIONS
  Limitations of the study include its retrospective design, lack of prestudy power calculation, possible inaccuracy of an administrative database, and selection bias.
  
  
  CONCLUSIONS
  Laparoscopic ventral rectopexy appears to be safe in select elderly patients.
authors: 1 Clinique de Chirurgie Digestive et Endocrinienne, University Hospital of Nantes, Nantes, France 2 Pelvic Floor Disorders Service, Department of Colorectal Surgery, Singapore General Hospital, Singapore 3 Service de Chirurgie Digestive, University Hospital of Poitiers, Poitiers, France.
authors: Fatma A
authors: FA
authors: Gultekin
authors: Mark T C
authors: MT
authors: Wong
authors: Juliette
authors: J
authors: Podevin
authors: Marie-Line
authors: ML
authors: Barussaud
authors: Myriam
authors: M
authors: Boutami
authors: Paul A
authors: PA
authors: Lehur
authors: Guillaume
authors: G
authors: Meurette
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D056887:Pelvic Organ Prolapse / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D011183:Postoperative Complications / Q000145:classification / Q000453:epidemiology; D011351:Proctoscopy / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D012005:Rectal Prolapse / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D012007:Rectum / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment