Outcome of Open Abdominal Rectopexy for the Treatment of Complete Rectal Prolapse –Our Experience in 20 Cases

Introduction: Complete rectal prolapse (procidentia) is a very troublesome condition. In adults, the only curative treatment for complete rectal prolapse is surgery either bytrans abdominal or perineal approaches. Among the all surgical procedure, the option of abdominal rectopexy , which can be done either by open procedure or laparoscopically, has become the treatment of choice for complete rectal prolapse. Objective: The purpose of this study is to see the outcome of open abdominal rectopexy for the treatment of complete rectal prolapse by subjective assessment. Methodology: The study was conducted in the Department of Surgery, Women’s Medical College Hospital and different private hospital in Sylhet District, from July 2013 to May 2021.A total of 20 Patients who presented with complete rectal prolapsed fulfilling the inclusion criteria were selected as study population. Laparotomy was done by lower midline incision and spinal anaesthesia was chosen for all the cases. Assessment of operative time, postoperative pain, mean days of hospital stay, constipation score, in continence score and recurrence rate within six months of follow-up were observed and recorded. Result: A total of 20 patients were included in this study of which 65% were female and 35% were male. The mean age was 48.80 (SD 11.50) years, the mean BMI was 24.1 (SD 2.35) and the mean time of operation was 80(SD 10.75) minutes. The mean VAS was 5.0(SD 1.25) on the day of first postoperative and 3.8(SD 1.15) on the second postoperative day. The mean days to resume bowel activity was 3.12 (SD 1.0) days. Postoperative hospital stay mean was 5.2 (SD 1.14) days. The constipation scores during preoperative and postoperative period were 3.8(SD 2.12) and 2.6 (SD 1.75) respectively. The mean in continence score during preoperative and postoperative period were 7.1 (SD 3.25) and 2.0 (SD 2.25) respectively. No recurrence case was found within six months of follow up period in this study. Conclusion: Open abdominal rectopexy is a safe, simple and effective procedure for the treatment of complete rectal prolapse.