Functional Outcome Of Laparoscopic Rectopexy With Or Without Resection In Cases Of Complete Rectal Prolapse

Background: Controversies regarding the management of rectal prolapse continue to stimulate interest in the study of its surgical treatment, as there is no single operation that is suitable for every patient with prolapse. With the evolution of laparoscopic surgery, both laparoscopic resection rectopexy and laparoscopic rectopexy with sutures or with mesh without resection has been described. This study aimed for evaluation of the functional outcome of both operations Laparoscopic rectopexy with or without sigmoid resection in patients with complete rectal prolapse. Patients and methods: This is a retrospective study which included the functional results of forty patients with complete rectal prolapse. Patients were divided into two groups; Group (A); were operated by laparoscopic rectopexy without resection, 8 patients were operated by suture rectopexy, and 12 patients were operated by mesh rectopexy. Group (B) [20 patients]; were operated by laparoscopic sigmoidectomy and suture rectopexy for patients who have redundant sigmoid colon. Their functional results regarding constipation, fecal incontinence, sexual and urological functions and also regarding recurrence were evaluated. Results: Constipation improved in 76% of patients and with more improvement in patient with resection rectopexy than with mesh or suture rectopexy. Fecal incontinence improved in 75% of patients regardless of which method was used. The effect on sexual and urologic functions were not found in any of our patients post-operatively during the period of follow up No recurrence was found in any of our patients post-operatively during the period of follow up. Conclusions: From our data we conclude that Laparoscopic surgery for rectal prolapse is a technically feasible method which resulted in improved constipation and incontinence in the great majority of patients with a significant increase in continence grade in our patients and eliminate the prolapse with nearly no recurrence. Laparoscopic surgery for rectal prolapse has the advantages of minimally invasive surgery including the shorter hospital stay, early recovery and return to work.