Reduced port laparoscopic rectopexy for full-thickness rectal prolapse.

IF 1.6 3区医学 Q2 SURGERY

BMC Surgery Pub Date : 2024-09-03 DOI:10.1186/s12893-024-02545-6

Chikako Kusunoki, Mamoru Uemura, Mao Osaki, Ayumi Nagae, Shinji Tokuyama, Kenji Kawai, Yusuke Takahashi, Masakazu Miyake, Michihiko Miyazaki, Masataka Ikeda, Takeshi Kato

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Abstract

Background: Laparoscopic rectopexy is an established treatment option for full-thickness rectal prolapse. Recently, reduced port surgery (RPS) has emerged as a novel concept, offering reduced postoperative pain and improved cosmetic outcomes compared with conventional multiport surgery (MPS). This study aimed to evaluate the feasibility and safety of RPS for full-thickness rectal prolapse.

Methods: From October 2012 to December 2018, 37 patients (MPS: 10 cases, RPS: 27 cases) underwent laparoscopic rectopexy for full-thickness rectal prolapse. Laparoscopic posterior mesh rectopexy (Wells procedure) is the standard technique for full-thickness rectal prolapse at our hospital. RPS was performed using a multi-channel access device, with an additional 12-mm right-hand port. Short-term outcomes were retrospectively compared between MPS and RPS.

Results: No significant differences were observed between MPS and RPS in the median operative time, the median blood loss volume, the postoperative complication rates, and median hospital stay duration after surgery.

Conclusion: Reduced port laparoscopic posterior mesh rectopexy may serve as an effective therapeutic option for full-thickness rectal prolapse. However, to establish the superiority of RPS over MPS, a prospective, randomized, controlled trial is warranted.

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减孔腹腔镜直肠切除术治疗全层直肠脱垂。

背景：腹腔镜直肠切除术是治疗全层直肠脱垂的成熟疗法。最近，缩孔手术（RPS）作为一种新概念出现，与传统的多孔手术（MPS）相比，它能减少术后疼痛，改善美容效果。本研究旨在评估RPS治疗全厚直肠脱垂的可行性和安全性：2012年10月至2018年12月，37例患者（MPS：10例，RPS：27例）接受了腹腔镜直肠切除术治疗全厚性直肠脱垂。腹腔镜后网状直肠切除术（Wells术）是我院治疗全厚直肠脱垂的标准技术。腹腔镜直肠切除术使用多通道入路装置进行，并增加了一个12毫米的右侧孔。我们对 MPS 和 RPS 的短期疗效进行了回顾性比较：结果：MPS和RPS在中位手术时间、中位失血量、术后并发症发生率以及术后中位住院时间方面均无明显差异：结论：减孔腹腔镜后网片直肠切除术是治疗全厚直肠脱垂的有效方法。结论：减孔腹腔镜后置网片直肠切除术可作为全厚性直肠脱垂的有效治疗方案，但要确定减孔腹腔镜直肠切除术优于后置网片直肠切除术，还需进行前瞻性随机对照试验。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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