Systematic Reviews
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 28, 2015; 21(16): 5049-5055
Published online Apr 28, 2015. doi: 10.3748/wjg.v21.i16.5049
Anterior rectopexy for full-thickness rectal prolapse: Technical and functional results
Jean-Luc Faucheron, Bertrand Trilling, Edouard Girard, Pierre-Yves Sage, Sandrine Barbois, Fabian Reche
Jean-Luc Faucheron, Bertrand Trilling, Edouard Girard, Pierre-Yves Sage, Sandrine Barbois, Fabian Reche, Colorectal Unit, Department of Surgery, University Hospital, 38043 Grenoble cedex, France
Author contributions: Faucheron JL, Trilling B, Girard E and Barbois S designed the study; Faucheron JL, Trilling B, Sage PY and Reche F performed the research; Faucheron JL, Trilling B and Girard E analyzed the data; Faucheron JL and Trilling B wrote the paper; Reche F and Barbois S reviewed the paper.
Conflict-of-interest: Jean-Luc Faucheron has received fees for serving as a speaker for Covidien, AMI, Ethicon, JNJ, and Medtronic. Bertrand Trilling, Edouard Girard, Sandrine Barbois, Pierre-Yves Sage, and Fabian Reche had no conflict of interest.
Data sharing: Technical appendix and dataset are available from the corresponding author at jlfaucheron@chu-grenoble.fr. No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jean-Luc Faucheron, MD, Professor of Surgery, Chief, Colorectal Unit, Department of Surgery, University Hospital, TIMC-IMAG Joseph Fourier University, CS 10217, 38043 Grenoble cedex, France. jlfaucheron@chu-grenoble.fr
Telephone: +33-4-76765371 Fax: +33-4-76768780
Received: May 27, 2014
Peer-review started: May 27, 2014
First decision: July 9, 2014
Revised: December 21, 2014
Accepted: February 11, 2015
Article in press: February 11, 2015
Published online: April 28, 2015
Processing time: 127 Days and 12.7 Hours
Abstract

AIM: To assess effectiveness, complications, recurrence rate, and recent improvements of the anterior rectopexy procedure for treatment of total rectal prolapse.

METHODS: MEDLINE, PubMed, EMBASE, and other relevant database were searched to identify studies. Randomized controlled trials, non-randomized studies and original articles in English language, with more than 10 patients who underwent laparoscopic ventral rectopexy for full-thickness rectal prolapse, with a follow-up over 3 mo were considered for the review.

RESULTS: Twelve non-randomized case series studies with 574 patients were included in the review. No surgical mortality was described. Conversion was needed in 17 cases (2.9%), most often due to difficult adhesiolysis. Twenty eight patients (4.8%) presented with major complications. Seven (1.2%) mesh-related complications were reported. Most frequent complications were urinary tract infection and urinary retention. Mean recurrence rate was 4.7% with a median follow-up of 23 mo. Improvement of constipation ranged from 3%-72% of the patients and worsening or new onset occurred in 0%-20%. Incontinence improved in 31%-84% patients who presented fecal incontinence at various stages. Evaluation of functional score was disparate between studies.

CONCLUSION: Based on the low long-term recurrence rate and favorable outcome data in terms of low de novo constipation rate, improvement of anal incontinence, and low complications rate, laparoscopic anterior rectopexy seems to emerge as an efficient procedure for the treatment of patients with total rectal prolapse.

Keywords: Total rectal prolapse; Laparoscopy; Anterior rectopexy; Ventral rectopexy; Results; Recurrence; Systematic review

Core tip: Several procedures have been described to correct full-thickness rectal prolapse. They can be separate into abdominal procedures and perineal procedures. Laparoscopic anterior rectopexy has become the procedure of choice for the treatment of total rectal prolapse in many colorectal surgical teams. This review assesses effectiveness, morbidity, recurrence rate, and recent improvements of the technique.