ABSTRACT

INTRODUCTION:

Rectal prolapse is an advanced age disease. The recurrence rate of abdominal rectopexy in rectal prolapse is generally lower than perineal approach. Abdominal rectopexy can be performed even laparoscopic or by open surgery. The aim of this study is to compare the laparoscopic and open rectopexy in rectal prolapse.

METHODS:

The patients who underwent laparoscopic or open abdominal rectopexy were included in this study. The patients’ demographics, type of the surgery, complications, length of hospital stay and the cost were obtained from the hospital data system. All patients’ data were confirmed by making phone calls and the patients’ complaints (recurrent, constipation, and anal incontinence) were recorded. Patients were evaluated in two groups as laparoscopic and open rectopexy.

RESULTS:

Of the 19 patients, 12 were female and 7 were male and the median age was 58 (27-83) years. Ten patients had undergone open and 9 patients had undergone laparoscopic rectopexy.

In 5 patients (26%) preoperative incontinence was present. After surgical treatment in 4(80%) patients, incontinence had improved. In one patient with psychotic disorder, incontinence had not resolved. Before the surgery 14(73%) cases had constipation and after the treatment resolution was observed in 11(78%) patients. However, in 3 cases of the constipation had not resolved.

The median follow-up was 18 (2-39) months. During the follow-up no mortality and no recurrence was observed in any of the patients. In laparoscopic group, the length of hospital stay was shorter (2.4 to 4.1 days) and the morbidity was lower when compared to the open rectopexy group. There was no difference between the two groups in terms of cost.

DISCUSSION AND CONCLUSION:

Laparoscopic rectopexy is as effective as open rectopexy in treatment of rectal prolapse. Laparoscopic rectopexy provides shorter hospital stay and low morbidity; therefore, it can be accepted as the first line treatment method in rectal prolapse.