title: Long-term Outcome After Laparoscopic Ventral Mesh Rectopexy: An Observational Study of 919 Consecutive Patients.
abstract: OBJECTIVE
  This multicenter study aims to assess long-term functional outcome, early and late (mesh-related) complications, and recurrences after laparoscopic ventral mesh rectopexy (LVR) for rectal prolapse syndromes in a large cohort of consecutive patients.
  
  
  BACKGROUND
  Long-term outcome data for prolapse repair are rare. A high incidence of mesh-related problems has been noted after transvaginal approaches using nonresorbable meshes.
  
  
  METHODS
  All patients treated with LVR at the Meander Medical Centre, Amersfoort, the Netherlands and the University Hospital Leuven, Belgium between January 1999 and March 2013 were enrolled in this study. All data were retrieved from a prospectively maintained database. Kaplan-Meier estimates were calculated for recurrences and mesh-related problems.
  
  
  RESULTS
  919 consecutive patients (869 women; 50 men) underwent LVR. A 10-year recurrence rate of 8.2% (95% confidence interval, 3.7-12.7) for external rectal prolapse repair was noted. Mesh-related complications were recorded in 18 patients (4.6%), of which mesh erosion to the vagina occurred in 7 patients (1.3%). In 5 of these patients, LVR was combined with a perineotomy. Both rates of fecal incontinence and obstructed defecation decreased significantly (P < 0.0001) after LVR compared to the preoperative incidence (11.1% vs 37.5% for incontinence and 15.6% vs 54.0% for constipation).
  
  
  CONCLUSIONS
  LVR is safe and effective for the treatment of different rectal prolapse syndromes. Long-term recurrence rates are in line with classic types of mesh rectopexy and occurrence of mesh-related complications is rare.
authors.affiliation: *Department of Surgery, Meander Medical Centre, Amersfoort, The Netherlands †Institute of Technical Medicine, Twente University, Enschede, The Netherlands ‡Department of Abdominal Surgery, University Hospital Gasthuisberg, Leuven, Belgium.
authors.forename: Esther C J
authors.initials: EC
authors.lastname: Consten
authors.forename: Jan J
authors.initials: JJ
authors.lastname: van Iersel
authors.forename: Paul M
authors.initials: PM
authors.lastname: Verheijen
authors.forename: Ivo A M J
authors.initials: IA
authors.lastname: Broeders
authors.forename: Albert M
authors.initials: AM
authors.lastname: Wolthuis
authors.forename: Andre
authors.initials: A
authors.lastname: D'Hoore
mesh_terms: D000328:Adult; D000368:Aged; D003672:Defecation / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012005:Rectal Prolapse / Q000503:physiopathology / Q000601:surgery*; D012007:Rectum / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D013526:Surgical Mesh; D013997:Time Factors; D016896:Treatment Outcome