Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Apr 27, 2016; 8(4): 321-325
Published online Apr 27, 2016. doi: 10.4240/wjgs.v8.i4.321
Laparoscopic ventral mesh rectopexy for complete rectal prolapse: A retrospective study evaluating outcomes in North Indian population
Abhijit Chandra, Saket Kumar, Ajeet Pratap Maurya, Vishal Gupta, Vivek Gupta, Rahul
Abhijit Chandra, Saket Kumar, Ajeet Pratap Maurya, Vishal Gupta, Vivek Gupta, Rahul, Department of Surgical Gastroenterology, King George’s Medical University, Lucknow 226003, Uttar Pradesh, India
Author contributions: Chandra A, Kumar S, Maurya AP and Gupta V contributed to planning and/or conducting the study; Chandra A, Kumar S, Maurya AP, Gupta V and Gupta V contributed to critical revision of the manuscript; Chandra A, Kumar S, Maurya AP and Rahul performed and/or assisted the surgical procedure, contributed to drafting the manuscript and literature review.
Institutional review board statement: Ethics Committee, Institutional Review Board, King George’s Medical University, Lucknow, India.
Informed consent statement: All involved persons gave their informed consent prior to study inclusion.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: 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: Abhijit Chandra, MCh, Professor, Department of Surgical Gastroenterology, King George’s Medical University, Shah Meena Road, Lucknow 226003, Uttar Pradesh, India. abhijitchandra@hotmail.com
Telephone: +91-522-2740068 Fax: +91-522-2256116
Received: June 29, 2015
Peer-review started: July 4, 2015
First decision: September 22, 2015
Revised: February 3, 2016
Accepted: February 23, 2016
Article in press: February 24, 2016
Published online: April 27, 2016
Abstract

AIM: To analyze the outcomes of laparoscopic ventral mesh rectopexy in the management of complete rectal prolapse (CRP) in North Indian patients with inherent bulky and redundant colon.

METHODS: The study was conducted at a tertiary health care center of North India. Between January 2010 and October 2014, 15 patients who underwent laparoscopic ventral mesh repair for CRP, were evaluated in the present study. Perioperative outcomes, improvement in bowel dysfunction or appearance of new complications were documented from the hospital records maintained prospectively.

RESULTS: Fifteen patients (9 female) with a median age of 50 years (range, 15-68) were included in the study. The median operative time was 200 min (range, 180-350 min) and the median post-operative stay was 4 d (range, 3-21 d). No operative mortality occurred. One patient with inadvertent small bowel injury required laparotomy on post-operative day 2. At a median follow-up of 22 mo (range, 4-54 mo), no prolapse recurrence was reported. No mesh-related complication was encountered. Wexner constipation score improved significantly from the preoperative value of 17 (range, 5-24) to 6 (range, 0-23) (P < 0.001) and the fecal incontinence severity index score from 24 (range, 0-53) to 2 (range, 0-53) (P = 0.007). No de novo constipation or fecal incontinence was recorded during the follow-up. On personal conversation, all patients expressed satisfaction with the outcome of their treatment.

CONCLUSION: Our experience indicates that laparoscopic ventral mesh rectopexy is an effective surgical option for CRP in North Indian patients having a bulky redundant colon.

Keywords: Redundant sigmoid, Constipation, Complete rectal prolapse, Ventral rectopexy, Indian population

Core tip: Laparoscopic ventral rectopexy is a new modality for surgical correction of full thickness rectal prolapse. Avoiding a circumferential mobilization of rectum and reperitonealization of the mesh decreases the complications of rectal denervation. Authors have emphasized the results of laparoscopic ventral rectopexy on bulky and redundant sigmoid which is prevalent in Indian population. Patients were studied for a median duration of 22 mo. There were a few post-operative complications which were easily managed. Marked improvement in constipation and incontinence scores were reported. No de novo or worsening of existing constipation was recorded in any of the patients. In this study, no recurrence was evident during the follow-up.