Long-term outcome of laparoscopic ventral rectopexy for full-thickness rectal prolapse: the PEXITY study.

IF 2.9 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Techniques in Coloproctology Pub Date : 2025-02-14 DOI:10.1007/s10151-024-03104-0

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.

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腹腔镜腹侧直肠切除术治疗全层直肠脱垂的长期疗效：peexity研究。

背景：腹腔镜腹网直肠固定术（LVR）在治疗全层直肠脱垂（RP）患者中越来越被接受，但关于至少10年随访的文献很少。我们研究了12年前因RP而进行LVR的患者的复发率、长期功能结果和生活质量。方法：研究人群为在2012年发表的175例RP行LVR的中短期预后的可接触的患者。我们通过临床检查、具体评分和问卷调查来研究患者的长期复发率（Kaplan-Meier）、功能结局（Wexner和ODS评分）、生活质量（EuroQol）和满意度。结果：175例患者中，14例符合排除标准，57例死亡，42例失访，剩下62例进行分析。在10年随访中，17例患者出现复发（10.5%）。唯一有统计学意义的复发危险因素是复发性RP （HR = 11.5 (2.54-52.2), P = 0.002）。大便失禁的中位评分为4(0-10)，复发患者的中位评分明显更差[12 (7-13)vs 3 (0-9)]；p = 0.016]。梗阻性排便评分中位数为6（3-12）。生活质量得分中位数为7分（6-8分）。大多数出现复发的患者表示，他们会再次接受手术，并建议进行手术，没有复发的患者也是如此。结论：LVR治疗RP是一种安全、有效、长期持续的技术，术后10年仍有长期疗效。

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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来源期刊

Techniques in Coloproctology GASTROENTEROLOGY & HEPATOLOGY-SURGERY

CiteScore

5.30

自引率

9.10%

发文量

176

审稿时长

1 months

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. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1965 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the Principles of Laboratory Animal Care (NIH publication no. 86-23 revised 1985) were followed as were applicable national laws (e.g. the current version of the German Law on the Protection of Animals). The Editor-in-Chief reserves the right to reject manuscripts that do not comply with the above-mentioned requirements. Authors will be held responsible for false statements or for failure to fulfill such requirements.