Treatment for full-thickness rectal prolapse using the abdominal access: An evaluation of 94 cases.

Abstract

<b>Introduction:</b> Full-thickness rectal prolapse (FTRP) is a multifactorial disease that can be treated with different surgicaltechniques. There is still no standard surgical procedure, and the selection of the surgical technique is based on the individualassessment and the experience of the surgeon. The benefits to patients should focus on repair of bowel prolapse, reduction ofconstipation, and an improvement in pelvic floor muscle insufficiency.<b>Aim:</b> Aim of this study was to evaluate clinical and functional outcomes after abdominal surgery for FTRP in a prospective single- -center observational study.<b>Materials and methods:</b> Between 2016 and 2022, a total of 94 consecutive patients (46.2 18.2 years) underwent abdominal surgery due to FTRP using an abdominal approach. They were operated on with ventral mesh rectopexy (VMR) (55 pts.) or resection and suture rectopexy - Frykman-Goldberg procedure (FG) (39 pts.). Before and after the surgery, clinical and functional outcomes were measured. The follow-up period ranged from 1 to 6 years (mean: 26 months).<b>Results:</b> At last follow-up, constipation occurred in 27.6% of VMR and 31.3% of FG patients (p = 0.754; calculated among patients with available postoperative constipation status). The Wexner incontinence score was significantly better in the VMR group (1.0 2.1 <i>vs.</i> 3.6 5.0, p = 0.009). There were no differences in the EQ5D indices between the groups (1.7 2.0 <i>vs.</i> 2.4 2.8, p = 0.257).<b>Conclusions:</b> Both surgical procedures revealed comparable rates of recurrence and complications. While QoL was similarbetween groups, VMR yielded a significantly greater improvement in the Wexner incontinence score.