M Barra, B Trilling, G Mastronicola, P-Y Sage, A Roudier, A Foote, F Tidadini, J Fournier, J-L Faucheron
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引用次数: 0
Abstract
Background: Laparoscopic ventral mesh rectopexy (LVR) has gained increasing acceptance for the treatment of patients with a full-thickness rectal prolapse (RP), but literature on follow-up of at least 10 years is scarce. We studied recurrence rate, long-term functional results and quality of life in patients who had LVR for RP more than 12 years ago.
Method: The study population consisted of patients who could be contacted among the 175 who had undergone LVR for RP and whose short- and medium-term outcomes were published in 2012. We studied the long-term recurrence rate (Kaplan-Meier), functional outcome (Wexner and ODS scores), quality of life (EuroQol) and satisfaction of the patient through clinical examination(s), specific scores and questionnaires.
Results: Of the 175 patients, 14 patients had exclusion criteria, 57 had died, and 42 were lost to follow-up, leaving 62 patients for analysis. Seventeen patients presented with a recurrence (10.5%) at the 10-year follow-up. The only statistically significant risk factor for recurrence was recurrent RP (HR = 11.5 (2.54-52.2), P = 0.002). The median faecal incontinence score was 4 (0-10) and significantly worse in patients who had a recurrence [12 (7-13) vs 3 (0-9); P = 0.016]. The median obstructive defaecation score was 6 (3-12). The median quality of life score was 7 (6-8). Most patients who presented with a recurrence said they would undergo the operation again and recommended it, as would patients with no recurrence.
Conclusion: LVR for RP is a safe and efficient technique with sustainable long-term results that shows long-term efficacy at > 10 years after the operation.
期刊介绍:
Techniques in Coloproctology is an international journal fully devoted to diagnostic and operative procedures carried out in the management of colorectal diseases. Imaging, clinical physiology, laparoscopy, open abdominal surgery and proctoperineology are the main topics covered by the journal. Reviews, original articles, technical notes and short communications with many detailed illustrations render this publication indispensable for coloproctologists and related specialists. Both surgeons and gastroenterologists are represented on the distinguished Editorial Board, together with pathologists, radiologists and basic scientists from all over the world. The journal is strongly recommended to those who wish to be updated on recent developments in the field, and improve the standards of their work.
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