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Techniques in Coloproctology

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01-02-2012 | Original Article

Focus on abdominal rectopexy for full-thickness rectal prolapse: meta-analysis of literature

Authors: F. Cadeddu, P. Sileri, M. Grande, E. De Luca, L. Franceschilli, G. Milito

Published in: Techniques in Coloproctology | Issue 1/2012

Abstract

Background

Laparoscopic rectopexy to treat full-thickness rectal prolapse has proven short-term benefits, but there are few long-term follow-up and functional outcome data available. Using meta-analysis techniques, this study was designed to evaluate long-term results of open and laparoscopic abdominal procedures to treat full-thickness rectal prolapse in adults.

Methods

A literature review was performed using the National Library of Medicine’s PubMed database. All articles on abdominal rectopexy patients with a follow-up longer than 16 months were considered. The primary end point was recurrence of rectal prolapse, and the secondary end points were improvement in incontinence and constipation. A random effect model was used to aggregate the studies reporting these outcomes, and heterogeneity was assessed.

Results

Eight comparative studies, consisting of a total of 467 patients (275 open and 192 laparoscopic), were included. Analysis of the data suggested that there is no significant difference in recurrence, incontinence and constipation improvement between laparoscopic abdominal rectopexy and open abdominal rectopexy. Considering non-comparative trials, the event rate for recurrence was similar in open and laparoscopic suture rectopexy studies and in open and laparoscopic mesh rectopexy trials. Improvement in constipation after the intervention was not statistically significant except for open mesh repair; postoperative improvement in incontinence was statistically significant after laparoscopic procedures and open mesh rectopexy.

Conclusions

Laparoscopic abdominal rectopexy is a safe and feasible procedure, which may compare equally with the open technique with regard to recurrence, incontinence and constipation. However, large-scale randomized trials, with comparative, strong methodology, are still needed to identify outcome measures accurately.

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Title: Focus on abdominal rectopexy for full-thickness rectal prolapse: meta-analysis of literature
Authors: F. Cadeddu
P. Sileri
M. Grande
E. De Luca
L. Franceschilli
G. Milito
Publication date: 01-02-2012
Publisher: Springer Milan
Published in: Techniques in Coloproctology / Issue 1/2012
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI: https://doi.org/10.1007/s10151-011-0798-x

At a glance: The STEP trials

Springer Medicine

Focus on abdominal rectopexy for full-thickness rectal prolapse: meta-analysis of literature

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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