Top

Surgical Endoscopy

Published in:

01-08-2019 | Rectal Prolapse | Review Article

Outcome of laparoscopic ventral mesh rectopexy for full-thickness external rectal prolapse: a systematic review, meta-analysis, and meta-regression analysis of the predictors for recurrence

Authors: Sameh Hany Emile, Hossam Elfeki, Mostafa Shalaby, Ahmad Sakr, Pierpaolo Sileri, Steven D. Wexner

Published in: Surgical Endoscopy | Issue 8/2019

Abstract

Background

Laparoscopic ventral mesh rectopexy (LVMR) has proved effective in the treatment of internal and external rectal prolapse. The present meta-analysis aimed to determine the predictive factors of recurrence of full-thickness external rectal prolapse after LVMR.

Methods

An organized, systematic search of electronic databases including PubMed/Medline, Embase, Scopus, and Cochran library was conducted in adherence to PRISMA guidelines. Studies that reported the outcome of LVMR in patients with full-thickness external rectal prolapse were included according to predefined criteria. A meta-regression analysis and sub-group meta-analyses were performed to recognize the patient and technical factors that were associated with higher recurrence rates.

Results

Seventeen studies comprising 1242 patients of a median age of 60 years were included. The median operation time was 122.3 min. Conversion to open surgery was required in 22 (1.8%) patients. The weighted mean complication rate across the studies was 12.4% (95% CI 8.4–16.4) and the weighted mean rate of recurrence of full-thickness external rectal prolapse was 2.8% (95% CI 1.4–4.3). The median follow-up duration was 23 months. Male gender (SE = 0.018, p = 0.008) and length of the mesh (SE = − 0.007, p = 0.025) were significantly associated with full-thickness recurrence of rectal prolapse. The weighted mean rates of improvement in fecal incontinence and constipation after LVMR were 79.3% and 71%, respectively.

Conclusion

LVMR is an effective and safe option in treatment of full-thickness external rectal prolapse with low recurrence and complication rates. Male patients and length of the mesh may potentially have a significant impact on recurrence of rectal prolapse after LVMR.

Gourgiotis S, Baratsis S (2007) Rectal prolapse. Int J Colorectal Dis 22(3):231–243CrossRefPubMed

Emile SH, Elfeki H, Shalaby M, Sakr A, Sileri P, Wexner SD (2017) Perineal resectional procedures for the treatment of complete rectal prolapse: a systematic review of the literature. Int J Surg 46:146–154. https://doi.org/10.1016/j.ijsu.2017.09.005 CrossRefPubMed

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

Faucheron JL, Trilling B, Girard E, Sage PY, Barbois S, Reche F (2015) Anterior rectopexy for full-thickness rectal prolapse: technical and functional results. World J Gastroenterol 21(16):5049–5055CrossRefPubMedPubMedCentral

Emile SH, Elfeki H, Youssef M, Farid M, Wexner SD (2017) Abdominal rectopexy for the treatment of internal rectal prolapse: a systematic review and meta-analysis. Colorectal Dis 19(1):O13–O24. https://doi.org/10.1111/codi.13574 CrossRefPubMed

Consten EC, van Iersel JJ, Verheijen PM, Broeders IA, Wolthuis AM, D’Hoore A (2015) Long-term outcome after laparoscopic ventral mesh rectopexy: an observational study of 919 consecutive patients. Ann Surg 262(5):742–747. https://doi.org/10.1097/sla.0000000000001401 discussion 747–748 CrossRefPubMed

Mathew MJ, Parmar AK, Reddy PK (2014) Mesh erosion after laparoscopic posterior rectopexy: a rare complication. J Minim Access Surg. 1(1):40–41. https://doi.org/10.4103/0972-9941.124473 CrossRef

Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 6(6):e1000097. https://doi.org/10.1371/journal.pmed1000097 CrossRefPubMedPubMedCentral

National Institute for Health and Clinical Excellence. NICE clinical guidelines, Appendix 4 Quality of case series form. https://www.nice.org.uk/guidance/cg3/documents/appendix-4-quality-of-case-series-form2

10.

Scottish Intercollegiate Guidelines Network (SIGN) guidelines, methodology checklist 3. http://www.sign.ac.uk/methodology/checklists.html

11.

Boons P, Collinson R, Cunningham C, Lindsey I (2010) Laparoscopic ventral rectopexy for external rectal prolapse improves constipation and avoids de novo constipation. Colorectal Dis 12(6):526–532. https://doi.org/10.1111/j.1463-1318.2009.01859.x CrossRefPubMed

12.

Wijffels N, Cunningham C, Dixon A, Greenslade G, Lindsey I (2011) Laparoscopic ventral rectopexy for external rectal prolapse is safe and effective in the elderly. Does this make perineal procedures obsolete? Colorectal Dis 13(5):561–566. https://doi.org/10.1111/j.1463-1318.2010.02242.x CrossRefPubMed

13.

Faucheron JL, Voirin D, Riboud R, Waroquet PA, Noel J (2012) Laparoscopic anterior rectopexy to the promontory for full-thickness rectal prolapse in 175 consecutive patients: short- and long-term follow-up. Dis Colon Rectum 55:660–665CrossRefPubMed

14.

Formijne Jonkers HA, Maya A, Draaisma WA, Bemelman WA, Broeders IA, Consten EC, Wexner SD (2014) Laparoscopic resection rectopexy versus laparoscopic ventral rectopexy for complete rectal prolapse. Tech Coloproctol 18(7):641–646. https://doi.org/10.1007/s10151-014-1122-3 CrossRefPubMed

15.

Mehmood RK, Parker J, Bhuvimanian L, Qasem E, Mohammed AA, Zeeshan M, Grugel K, Carter P, Ahmed S (2014) Short-term outcome of laparoscopic versus robotic ventral mesh rectopexy for full-thickness rectal prolapse. Is robotic superior? Int J Colorectal Dis 29(9):1113–1118. https://doi.org/10.1007/s00384-014-1937-4 CrossRefPubMed

16.

Bjerke T, Mynster T (2014) Laparoscopic ventral rectopexy in an elderly population with external rectal prolapse: clinical and anal manometric results. Int J Colorectal Dis 29(10):1257–1262. https://doi.org/10.1007/s00384-014-1960-5 CrossRefPubMed

17.

Randall J, Smyth E, McCarthy K, Dixon AR (2014) Outcome of laparoscopic ventral mesh rectopexy for external rectal prolapse. Colorectal Dis 16(11):914–919. https://doi.org/10.1111/codi.12741 CrossRefPubMed

18.

Gosselink MP, Joshi H, Adusumilli S, van Onkelen RS, Fourie S, Hompes R, Jones OM, Cunningham C, Lindsey I (2015) Laparoscopic ventral rectopexy for faecal incontinence: equivalent benefit is seen in internal and external rectal prolapse. J Gastrointest Surg. 19(3):558–563. https://doi.org/10.1007/s11605-014-2696-9 CrossRefPubMed

19.

Chandra A, Kumar S, Maurya AP, Gupta V, Gupta V (2016) Laparoscopic ventral mesh rectopexy for complete rectal prolapse: a retrospective study evaluating outcomes in North Indian population. World J Gastrointest Surg 8(4):321–325. https://doi.org/10.4240/wjgs.v8.i4.321 CrossRefPubMedPubMedCentral

20.

Rautio T, Mäkelä-Kaikkonen J, Vaarala M, Kairaluoma M, Kössi J, Carpelan-Holmström M, Salmenkylä S, Ohtonen P, Mäkelä J (2016) Laparoscopic ventral rectopexy in male patients with external rectal prolapse is associated with a high reoperation rate. Tech Coloproctol 20(10):715–720. https://doi.org/10.1007/s10151-016-1528-1 CrossRefPubMed

21.

Lundby L, Iversen LH, Buntzen S, Wara P, Høyer K, Laurberg S (2016) Bowel function after laparoscopic posterior sutured rectopexy versus ventral mesh rectopexy for rectal prolapse: a double-blind, randomised single-centre study. Lancet Gastroenterol Hepatol. 1(4):291–297. https://doi.org/10.1016/S2468-1253(16)30085-1 CrossRefPubMed

22.

Emile SH, Elbanna H, Youssef M, Thabet W, Omar W, Elshobaky A, Abd El-Hamed TM, Farid M (2017) Laparoscopic ventral mesh rectopexy vs Delorme’s operation in management of complete rectal prolapse: a prospective randomized study. Colorectal Dis 19(1):50–57. https://doi.org/10.1111/codi.13399 CrossRefPubMed

23.

Luglio G, Tarquini R, Giglio MC, Sollazzo V, Peltrini R, Sacco M, Spiezio G, Amato B, De Palma GD, Bucci L (2017) Ventral mesh rectopexy versus conventional suture technique: a single-institutional experience. Aging Clin Exp Res 29(Suppl 1):79–82. https://doi.org/10.1007/s40520-016-0672-9 CrossRefPubMed

24.

Fu CW, Stevenson AR (2017) Risk factors for recurrence after laparoscopic ventral rectopexy. Dis Colon Rectum 60(2):178–186. https://doi.org/10.1097/DCR.0000000000000710 CrossRefPubMed

25.

Madbouly KM, Youssef M (2018) Laparoscopic ventral rectopexy versus laparoscopic wells rectopexy for complete rectal prolapse: long-term results. J Laparoendosc Adv Surg Tech A. 28(1):1–6. https://doi.org/10.1089/lap.2017.0012 CrossRefPubMed

26.

Chandra A, Singh P, Kumar S, Chopra N, Gupta V, Joshi P, Gupta V (2018) Laparoscopic ventral rectopexy: a viable option in procidentia with redundant sigmoid—an Indian perspective. J Minim Access Surg. 14(4):304–310. https://doi.org/10.4103/jmas.jmas_106_17 CrossRefPubMedPubMedCentral

27.

Adeyemo D (2013) Mesh fistulation into the rectum after laparoscopic ventral mesh rectopexy. Int J Surg Case Rep. 5(3):152–154CrossRefPubMedPubMedCentral

28.

Blaker K, Anandam JL (2017) Functional disorders: rectoanal intussusception. Clin Colon Rectal Surg 30(1):5–11CrossRefPubMedPubMedCentral

29.

Dvorkin LS, Gladman MA, Scott SM, Williams NS, Lunniss PJ (2005) Rectal intussusception: a study of rectal biomechanics and visceroperception. Am J Gastroenterol 100(7):1578–1585CrossRefPubMed

30.

Rakinic J. Rectal prolapse. Medscape. https://emedicine.medscape.com/article/2026460-overview#a7. Accessed on Dec 4, 2018/

31.

Owais AE, Sumrien H, Mabey K, McCarthy K, Greenslade GL, Dixon AR (2014) Laparoscopic ventral mesh rectopexy in male patients with internal or external rectal prolapse. Colorectal Dis 16(12):995–1000. https://doi.org/10.1111/codi.12763 CrossRefPubMed

32.

Badrek-Al Amoudi AH, Greenslade GL, Dixon AR (2013) How to deal with complications after laparoscopic ventral mesh rectopexy: lessons learnt from a tertiary referral centre. Colorectal Dis 15:707–712CrossRefPubMed

33.

Mackenzie H, Dixon AR (2014) Proficiency gain curve and predictors of outcome for laparoscopic ventral mesh rectopexy. Surgery 156:158–167CrossRefPubMed

34.

Hwang YH (2013) Role of the Delorme procedure for rectal prolapse in young patients. Ann Coloproctol 29:41CrossRefPubMedPubMedCentral

35.

Shalaby M, Polisca P, Missori G, Sileri P (2016) Hiatal hernia, mitral valve prolapse and defecatory disorders: An underlying rectal prolapse? Tech Coloproctol 20(5):337–338. https://doi.org/10.1007/s10151-016-1442-6 CrossRefPubMed

36.

Lee UJ, Kerkhof MH, van Leijsen SA, Heesakkers JP (2017) Obesity and pelvic organ prolapse. Curr Opin Urol 27(5):428–434. https://doi.org/10.1097/MOU.0000000000000428 CrossRefPubMed

37.

Cuicchi D, Lombardi R, Cariani S, Leuratti L, Lecce F, Cola B (2013) Clinical and instrumental evaluation of pelvic floor disorders before and after bariatric surgery in obese women. Surg Obes Relat Dis 9:69–75CrossRefPubMed

38.

Mercer-Jones MA, D’Hoore A, Dixon AR, Lehur P, Lindsey I, Mellgren A, Stevenson AR (2014) Consensus on ventral rectopexy: report of a panel of experts. Colorectal Dis 16(2):82–88. https://doi.org/10.1111/codi.1241 CrossRefPubMed

39.

Balla A, Quaresima S, Smolarek S, Shalaby M, Missori G, Sileri P (2017) Synthetic versus biological mesh-related erosion after laparoscopic ventral mesh rectopexy: a systematic review. Ann Coloproctol. 33(2):46–51. https://doi.org/10.3393/ac.2017.33.2.46 CrossRefPubMedPubMedCentral

40.

Formijne Jonkers HA, van de Haar HJ, Draaisma WA, Heggelman BG, Consten EC, Broeders IA (2012) The optimal strategy for proximal mesh fixation during laparoscopic ventral rectopexy for rectal prolapse: an ex vivo study. Surg Endosc 26(8):2208–2212. https://doi.org/10.1007/s00464-012-2161-3 CrossRefPubMed

41.

Pucher PH, Mayo D, Dixon AR, Clarke A, Lamparelli MJ (2017) Learning curves and surgical outcomes for proctored adoption of laparoscopic ventral mesh rectopexy: cumulative sum curve analysis. Surg Endosc 31(3):1421–1426. https://doi.org/10.1007/s00464-016-5132-2 CrossRefPubMed

42.

Mercer-Jones MA, Brown SR, Knowles CH, Williams AB (2017) Position Statement by The Pelvic Floor Society on behalf of The Association of Coloproctology of Great Britain and Ireland on the use of mesh in ventral mesh rectopexy (VMR). Colorectal Dis. https://doi.org/10.1111/codi.13893 CrossRefPubMed

Title: Outcome of laparoscopic ventral mesh rectopexy for full-thickness external rectal prolapse: a systematic review, meta-analysis, and meta-regression analysis of the predictors for recurrence
Authors: Sameh Hany Emile
Hossam Elfeki
Mostafa Shalaby
Ahmad Sakr
Pierpaolo Sileri
Steven D. Wexner
Publication date: 01-08-2019
Publisher: Springer US
Keywords: Rectal Prolapse
Fecal Incontinence
Rectopexy
Published in: Surgical Endoscopy / Issue 8/2019
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-019-06803-0

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Outcome of laparoscopic ventral mesh rectopexy for full-thickness external rectal prolapse: a systematic review, meta-analysis, and meta-regression analysis of the predictors for recurrence

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 8/2019

False-negative double-balloon enteroscopy in overt small bowel bleeding: long-term follow-up after negative results

Correction to: Validation of a virtual intracorporeal suturing simulator

Incidence and predictors of postoperative ileus after loop ileostomy closure: a systematic review and meta-analysis

Pure laparoscopic living donor hepatectomy using the Glissonean pedicle approach (with video)

Effect of revisional bariatric surgery on type 2 diabetes mellitus

Open versus laparoscopic hepatic resection for hepatocellular carcinoma: a systematic review and meta-analysis