title: [Laparoscopic resection rectopexy in the treatment of obstructive defecation syndrome].
abstract: BACKGROUND
  Obstructive defecation syndrome (ODS) presents a common medical problem, which can be caused by various pelvic disorders; multiple disorders are frequently diagnosed. At the present, a high number of corrective techniques are available via various surgical approaches. Laparoscopic resection rectopexy is a minimally invasive technique, which comprises redundant sigmoidal resection with rectal mobilisation and fixation.
  
  
  METHODS
  The aim of this paper was to evaluate the safety and effectiveness of laparoscopic resection rectopexy in the treatment of patients with ODS. The evaluation was performed via our own patients data analysis and via literature search focused on laparoscopic resection rectopexy.
  
  
  RESULTS
  In total, 12 patients with ODS undergoing laparoscopic resection rectopexy in University Hospital Ostrava during the study period (2012-2015) were included in the study. In our study group, mean age was 64.5 years and mean BMI was 21.9; the group included 11 women (91.6%). ODS was caused by multiple pelvic disorders in all patients. Dolichosigmoideum and rectal prolapse (internal or external) were diagnosed in all included patients. On top of that, rectocoele and enterocoele were diagnosed in several patients. Laparoscopic resection rectopexy was performed without intraoperative complications; mean operative time was 144 minutes. Mean postoperative length of hospital stay was 7 days. Postoperative 30-day morbidity was 16.6%. All postoperative complications were classified as grade II according to Clavien-Dindo classification. Mean preoperative Wexner score was 23.6 points; mean score 6 months after the surgery was 11.3 points. Significant improvement in ODS symptoms was noted in 58.3% of patients, and a slight improvement in 16.6% of patients; resection rectopexy provided no clinical effect in 25% of patients.
  
  
  CONCLUSIONS
  It is fundamental to carefully select those patients with ODS who could possibly profit from the surgery. Our results, in accordance with published data, suggest that laparoscopic resection rectopexy is a valuable surgical technique in the treatment of patients with ODS caused by multiple pelvic disorders.
  
  
  BACKGROUND
  obstructive defecation syndrome - constipation - resection rectopexy - operative techniques - pelvic floor disorders.
authors.forename: P
authors.initials: P
authors.lastname: Ihnát
authors.forename: P
authors.initials: P
authors.lastname: Guňková
authors.forename: P
authors.initials: P
authors.lastname: Vávra
authors.forename: M
authors.initials: M
authors.lastname: Lerch
authors.forename: M
authors.initials: M
authors.lastname: Peteja
authors.forename: A
authors.initials: A
authors.lastname: Pelikán
authors.forename: P
authors.initials: P
authors.lastname: Zonča
mesh_terms: D000368:Aged; D012809:Colon, Sigmoid / Q000601:surgery*; D003248:Constipation / Q000601:surgery*; D003672:Defecation; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005260:Female; D006547:Hernia / Q000150:complications; D059685:Herniorrhaphy; D006801:Humans; D007415:Intestinal Obstruction / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D059952:Pelvic Floor Disorders / Q000601:surgery*; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000379:methods*; D012005:Rectal Prolapse / Q000601:surgery*; D020047:Rectocele / Q000150:complications / Q000601:surgery; D012007:Rectum / Q000601:surgery*; D016896:Treatment Outcome