Laparoscopic Posterolateral Rectopexy for the Treatment of Patients With a Full Thickness Rectal Prolapse: Experience With 63 Patients and Short-term Outcomes

현기훈; 양시준; 임기윤; 이종균; 윤서구

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자료유형: 학술저널

저자정보: 현기훈 (서울송도병원) 양시준 (서울송도병원) 임기윤 (서울송도병원) 이종균 (서울송도병원) 윤서구 (서울송도병원)

저널정보: 대한대장항문학회 Annals of Coloproctology Annals of Coloproctolgy Vol.34 No.3

발행연도: 2018.1

수록면: 119 - 124 (6page)

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Purpose: Although numerous procedures have been proposed for the treatment of patients with a rectal prolapse, the most effective operation has not yet been established. Minimal rectal mobilization can prevent constipation; however, it is associated with increased recurrence rates. We describe our novel method for a laparoscopic posterolateral rectopexy, which includes rectal mobilization with a posterior-right unilateral dissection, suture fixation to the sacral promontory with a polypropylene mesh (Optilene), and a mesorectal fascia propria that is as wide as possible. The present report describes our novel method and assesses the short-term outcomes of patients. Methods: Between June 2014 and June 2017, 63 patients (28 males and 35 females) with a full-thickness rectal prolapse underwent a laparoscopic posterolateral (LPL) rectopexy. We retrospectively analyzed the clinical characteristics and postoperative complications in those patients. The outcome of surgery was determined by evaluating the answers on fecal incontinence questionnaires, the results of anal manometry preoperatively and 3 months postoperatively, the patients’ satisfaction scores (0–10), and the occurrence of constipation. Results: No recurrence was reported during follow-up (3.26 months), and 3 patients reported postoperative complications (wound infection, postoperative sepsis, which was successfully treated with conservative management, and retrograde ejaculation). Compared to the preoperative baseline, fecal incontinence at three months postoperatively showed an overall improvement. The mean patient satisfaction score was 9.55 ± 0.10, and 8 patients complained of persistent constipation. Conclusion: LPL rectopexy is a safe, effective method showing good functional outcomes by providing firm, solid fixation for patients with a full-thickness rectal prolapse.

참고문헌 (30)

참고문헌 신청

Bordeianou L / 2014 / Rectal prolapse: an overview of clinical features, diagnosis, and patient-specific management strategies / J Gastrointest Surg 18:1059~1069

윤서구 / 2011 / Rectal Prolapse: Review According to the Personal Experience / Annals of Coloproctolgy 27(3):107~113

D'Hoore A / 2004 / Long-term outcome of laparoscopic ventral rectopexy for total rectal prolapse / Br J Surg 91:1500~1505

Formijne Jonkers HA / 2013 / Laparoscopic ventral rectopexy for rectal prolapse and symptomatic rectocele: an analysis of 245 consecutive patients / Colorectal Dis 15:695~699

Mercer-Jones MA / 2014 / Consensus on ventral rectopexy: report of a panel of experts / Colorectal Dis 16:82~88

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