Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
International Journal of Colorectal Disease
Published in: International Journal of Colorectal Disease 10/2019

01-10-2019 | Enterostomy | Original Article

Ventral rectopexy with biological mesh for recurrent disorders of the posterior pelvic organ compartment

Authors: M. Brunner, H. Roth, K. Günther, R. Grützmann, Klaus E. Matzel

Published in: International Journal of Colorectal Disease | Issue 10/2019

Login to get access

Abstract

Purpose

Recurrent prolapse of the posterior pelvic organ compartment presents a management challenge, with the best surgical procedure remaining unclear. We present functional outcome and patient satisfaction after laparoscopic and robotic ventral mesh rectopexy (VMR) with biological mesh in patients with recurrence.

Methods

We analyzed data from 30 patients with recurrent posterior pelvic organ prolapse who underwent VMR with biological mesh from August 2012 to January 2018. Data included patient demographics and intra- and postoperative findings; functional outcome as assessed by Cleveland Clinic Constipation Score (CCCS), Obstructed Defecation Score Longo (ODS), and Cleveland Clinic Incontinence Score (CCIS); and patient satisfaction.

Results

CCCS, CCIS, and ODS were significantly improved at 6–12 months postoperatively and at last follow-up. Patient satisfaction (visual analog scale [VAS] 6.7 [0 to 10]), subjective symptoms (+ 3.4 [scale − 5 to + 5]), and quality of life improvement (+ 3.0 [scale from − 5 to + 5]) were high at last follow-up. The rates of morbidity and major complications were 13% and 3%, respectively. There were no mesh-related complications or deaths. Difference in type of previous surgery (abdominal or transanal/perineal) had no significant effect on results.

Conclusions

VMR with biological mesh is a safe and effective option for patients with recurrent posterior pelvic organ prolapse. It reduces functional symptoms, has a low complication rate, and promotes patient satisfaction.
Literature
1.
Xynos E (2012) Functional results after surgery for overt rectal prolapse. Acta Chir Iugosl 59:21–24CrossRefPubMed
2.
Formijne Jonkers HA, Draaisma WA, Wexner SD, Broeders IAMJ, Bemelman WA, Lindsey I, Consten ECJ (2013) Evaluation and surgical treatment of rectal prolapse: an international survey. Color Dis 15(1):115–119CrossRef
3.
D'Hoore A, Cadoni R, Penninckx F (2004) Long-term outcome of laparoscopic ventral rectopexy for total rectal prolapse. Br J Surg 91(11):1500–1505CrossRefPubMed
4.
van Iersel JJ, Paulides TJ, Verheijen PM et al (2016) Current status of laparoscopic and robotic ventral mesh rectopexy for external and internal rectal prolapse. World J Gastroenterol 22(21):4977–4987CrossRefPubMedPubMedCentral
5.
Boons P, Collinson R, Cunningham C, Lindsey I (2010) Laparoscopic ventral rectopexy for external rectal prolapse improves constipation and avoids de novo constipation. Color Dis 12(6):526–532CrossRef
6.
Solomon MJ, Young CJ, Eyers AA, Roberts RA (2002) Randomized clinical trial of laparoscopic versus open abdominal rectopexy for rectal prolapse. Br J Surg 89(1):35–39CrossRefPubMed
7.
Balla A, Quaresima S, Smolarek S, Shalaby M, Missori G, Sileri P (2017) Synthetic versus biological mesh-related erosion after laparoscopic ventral mesh rectopexy: asystematic review. Ann Coloproctol 33(2):46–51CrossRefPubMedPubMedCentral
8.
Smart NJ, Pathak S, Boorman P, Daniels IR (2013) Synthetic or biological mesh use in laparoscopic ventral mesh rectopexy--a systematic review. Color Dis 15(6):650–654CrossRef
9.
Consten EC, van Iersel JJ, Verheijen PM et al (2015) Along-term outcome after laparoscopic ventral mesh rectopexy: an observational study of 919 consecutive patients. Ann Surg 262:742–747 discussion 747-748CrossRefPubMed
10.
Mackenzie H, Dixon AR (2014) Proficiency gain curve and predictors of outcome for laparoscopic ventral mesh rectopexy. Surgery 156:158–167CrossRefPubMed
11.
Brunner M, Roth H, Günther K, Grützmann R, Matzel KE (2018) Ventral rectopexy with biological mesh: short-term functional results. Int J Color Dis 33(4):449–457CrossRef
12.
Raftopoulos Y, Senagore AJ, Di Giuro G, Bergamaschi R (2005) Rectal prolapse recurrence study group. Recurrence rates after abdominal surgery for complete rectal prolapse: a multicenter pooled analysis of 643 individual patient data. Dis Colon Rectum 48(6):1200–1206CrossRefPubMed
13.
Senapati A, Gray RG, Middleton LJ, Harding J, Hills RK, Armitage NC, Buckley L, Northover JM, PROSPER Collaborative Group (2013) PROSPER: a randomised comparison of surgical treatments for rectal prolapse. Color Dis 15(7):858–868CrossRef
14.
Hotouras A, Ribas Y, Zakeri S, Bhan C, Wexner SD, Chan CL, Murphy J (2015) A systematic review of the literature on the surgical management of recurrent rectal pro-lapse. Color Dis 17:657–664CrossRef
15.
Gurland B, Carvalho M, Ridgeway B et al (2017) Should we offer ventral rectopexy to patients with recurrent external rectal prolapse? Int J Color Dis 32:1561–1567CrossRef
16.
Agachan F, Chen T, Pfeifer J, Reissman P, Wexner SD (1996) A constipation scoring system to simplify evaluation and management of constipated patients. Dis Colon Rectum 39:681–685CrossRefPubMed
17.
Longo A (December 2006) 3rd German-Italian experts meeting, Rome, pp 12–14
18.
Jorge JM, Wexner SD (1993) Etiology and management of fecal incontinence. Dis Colon Rectum 36:77–97CrossRefPubMed
Metadata
Title
Ventral rectopexy with biological mesh for recurrent disorders of the posterior pelvic organ compartment
Authors
M. Brunner
H. Roth
K. Günther
R. Grützmann
Klaus E. Matzel
Publication date
01-10-2019
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Colorectal Disease / Issue 10/2019
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-019-03363-6

Other articles of this Issue 10/2019

International Journal of Colorectal Disease 10/2019 Go to the issue

Original Article

Familial and non-familial risk factors associated with colorectal cancer survival in young and middle-aged patients

Short Communication

Normal colonic transit time predicts the outcome of colonic manometry in patients with chronic constipation—an exploratory study

Original Article

Emergent colectomy rates decreased while elective ileal pouch rates were stable over time: a nationwide inpatient sample study

Original Article

Incidence of wound dehiscence after colorectal cancer surgery: results from a national population-based register for colorectal cancer

Original Article

Additional surgery after endoscopic submucosal dissection for colorectal cancer: a review of 53 cases

Review

Outcomes following colonic stenting for malignant left-sided bowel obstruction: a systematic review of randomised controlled trials