Functional results after laparoscopic rectopexy for rectal prolapse

被引:40
|
作者
Zittel, TT
Manncke, K
Haug, S
Schäfer, JF
Kreis, ME
Becker, HD
Jehle, EC
机构
[1] Univ Tubingen Hosp, Dept Gen Surg, D-72076 Tubingen, Germany
[2] Univ Tubingen Hosp, Dept Radiol, D-72076 Tubingen, Germany
关键词
rectal prolapse; intussusception; laparoscopic rectopexy; functional results; anorectal manometry;
D O I
10.1016/S1091-255X(00)80114-6
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
We investigated the functional results after laparoscopic rectopexy for rectal prolapse in 29 patients at least 12 months postoperatively. Twenty patients were evaluated completely pre- and postoperatively (median 22 months postoperatively; range 12 to 54 months). Six patients were interviewed by telephone, two patients were lost to follow-up, and one patient died of causes unrelated to rectal prolapse. Patients underwent a proctologic examination, anoscopy, rigid sigmoidoscopy, fluoroscopic defecography, and anorectal manometry pre- and postoperatively and an additional standardized interview postoperatively, Anorectal manometry showed a significant Increase in maximum anal resting and squeeze pressures postoperatively (resting pressure 72 +/- 8 vs. 95 +/- 13 mm Hg, pre- vs. postoperatively; P = 0.046; squeeze pressure 105 +/- 17 vs. 142 +/- 19 mm Hg, pre- vs, postoperatively; P = 0.035), and continence improved postoperatively (Wexner incontinence score 6.0 +/- 1.0 vs. 3.5 +/- 0.8 pre- vs. postoperatively P = 0.02). Twenty (77%) of 26 patients were satisfied with the operative result, but functional morbidity was observed in four patients, with two patients complaining of severe evacuation problems. Rectal prolapse recurred in one patient 42 months postoperatively (recurrence rate 1 [3.8%] of 26 patients). Functional results M ere very similar to those obtained after open rectopexy with symptoms of prolapse and incontinence improved in the great majority of patients.
引用
收藏
页码:632 / 641
页数:10
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