Literature DB >> 31183789

Long-term outcomes of robotic ventral mesh rectopexy for external rectal prolapse.

Agathe Postillon1, Cyril Perrenot2, Adeline Germain2, Marie-Lorraine Scherrer2, Cyrille Buisset2, Laurent Brunaud2, Ahmet Ayav2, Laurent Bresler2.   

Abstract

INTRODUCTION: Nowadays in Europe, laparoscopic ventral mesh rectopexy is the gold standard treatment of external rectal prolapse (ERP). The benefits of robot ventral mesh rectopexy (RVMR) are not clearly defined. The primary objective of the study was to evaluate the long-term results of RVMR. The secondary objective was to determine predictive factors of recurrence.
DESIGN: Monocentric, retrospective study. Data, both pre-operative and peri-operative, were collected, and follow-up data were assessed prospectively by a telephone questionnaire. The study was performed in a tertiary referral center.
METHODS: Between August 2007 and August 2017, we evaluate all consecutive patients who underwent RVMR for ERP by three different surgeons. The primary outcome was the recurrence rate perceived by patients. Secondary outcome were functional results based on Knowles-Eccersley-Scott-Symptom score for constipation and Wexner score for incontinence, compared before and after surgery.
RESULTS: During the study period 96 patients (86 women) underwent RVMR. The mean age was 62.3 years (range 16-90). Twelve patients had a history of ERP repair. Sixty-nine patients were analyzed for long-term outcomes with a mean follow-up of 37 months (range 2.3-92 months). Recurrence rate was 12.5%. After surgery, constipation was significantly reduced: 44 patients were constipated before surgery versus 23 after surgery. Six patients described de novo constipation (6.25%). Fecal incontinence was significantly reduced: 59 patients were incontinent before surgery versus 14 after surgery. No predictive factor for recurrence was identified after multivariate analysis. No mesh related complications were related.
CONCLUSIONS: In conclusion, RVMR presents good long-term functional result and a recurrence rate similar to LVMR as published in the literature. The rate of mesh related complications seems lower.

Entities:  

Keywords:  Constipation; Fecal incontinence; Rectal prolapse; Rectopexy; Recurrence; Robotics

Mesh:

Year:  2019        PMID: 31183789     DOI: 10.1007/s00464-019-06851-6

Source DB:  PubMed          Journal:  Surg Endosc        ISSN: 0930-2794            Impact factor:   4.584


  39 in total

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5.  Value of robotic colorectal surgery.

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6.  Robotic ventral mesh rectopexy for rectal prolapse: a single-institution experience.

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8.  Risk Factors for Recurrence After Laparoscopic Ventral Rectopexy.

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10.  Long-term Outcome After Laparoscopic Ventral Mesh Rectopexy: An Observational Study of 919 Consecutive Patients.

Authors:  Esther C J Consten; Jan J van Iersel; Paul M Verheijen; Ivo A M J Broeders; Albert M Wolthuis; Andre D'Hoore
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Review 3.  Mesh-related complications and recurrence after ventral mesh rectopexy with synthetic versus biologic mesh: a systematic review and meta-analysis.

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4.  Redo ventral rectopexy: is it worthwhile?

Authors:  K E Laitakari; J K Mäkelä-Kaikkonen; M Kairaluoma; A Junttila; J Kössi; P Ohtonen; T T Rautio
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  4 in total

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