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Surgical Treatment of Rectal Prolapse in the Laparoscopic Era; A Review of the Literature

Rectal prolapse is associated with debilitating symptoms including the discomfort of prolapsing tissue, mucus discharge, hemorrhage, and defecation disorders of fecal incontinence, constipation, or both. The aim of treatment is to eliminate the prolapse, correct associated bowel function and prevent...

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Autor principal: Tsunoda, Akira
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japan Society of Coloproctology 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7390613/
https://www.ncbi.nlm.nih.gov/pubmed/32743110
http://dx.doi.org/10.23922/jarc.2019-035
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author Tsunoda, Akira
author_facet Tsunoda, Akira
author_sort Tsunoda, Akira
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description Rectal prolapse is associated with debilitating symptoms including the discomfort of prolapsing tissue, mucus discharge, hemorrhage, and defecation disorders of fecal incontinence, constipation, or both. The aim of treatment is to eliminate the prolapse, correct associated bowel function and prevent new onset of bowel dysfunction. Historically, abdominal procedures have been indicated for young fit patients, whereas perineal approaches have been preferred in older frail patients with significant comorbidity. Recently, the laparoscopic procedures with their advantages of less pain, early recovery, and lower morbidity have emerged as an effective tool for the treatment of rectal prolapse. This article aimed to review the current evidence base for laparoscopic procedures and perineal procedures, and to compare the results of various techniques. As a result, laparoscopic procedures showed a relatively low recurrence rate than the perineal procedures with comparable complication rates. Laparoscopic resection rectopexy and laparoscopic ventral mesh rectopexy had a small advantage in the improvement of constipation or the prevention of new-onset constipation compared with other laparoscopic procedures. However, the optimal surgical repair has not been clearly demonstrated because of the significant heterogeneity of available studies. An individualized approach is recommended for every patient, considering age, comorbidity, and the underlying anatomical and functional disorders.
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spelling pubmed-73906132020-07-31 Surgical Treatment of Rectal Prolapse in the Laparoscopic Era; A Review of the Literature Tsunoda, Akira J Anus Rectum Colon Review Article Rectal prolapse is associated with debilitating symptoms including the discomfort of prolapsing tissue, mucus discharge, hemorrhage, and defecation disorders of fecal incontinence, constipation, or both. The aim of treatment is to eliminate the prolapse, correct associated bowel function and prevent new onset of bowel dysfunction. Historically, abdominal procedures have been indicated for young fit patients, whereas perineal approaches have been preferred in older frail patients with significant comorbidity. Recently, the laparoscopic procedures with their advantages of less pain, early recovery, and lower morbidity have emerged as an effective tool for the treatment of rectal prolapse. This article aimed to review the current evidence base for laparoscopic procedures and perineal procedures, and to compare the results of various techniques. As a result, laparoscopic procedures showed a relatively low recurrence rate than the perineal procedures with comparable complication rates. Laparoscopic resection rectopexy and laparoscopic ventral mesh rectopexy had a small advantage in the improvement of constipation or the prevention of new-onset constipation compared with other laparoscopic procedures. However, the optimal surgical repair has not been clearly demonstrated because of the significant heterogeneity of available studies. An individualized approach is recommended for every patient, considering age, comorbidity, and the underlying anatomical and functional disorders. The Japan Society of Coloproctology 2020-07-30 /pmc/articles/PMC7390613/ /pubmed/32743110 http://dx.doi.org/10.23922/jarc.2019-035 Text en Copyright © 2020 by The Japan Society of Coloproctology https://creativecommons.org/licenses/by-nc-nd/4.0/ Journal of the Anus, Rectum and Colon is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Review Article
Tsunoda, Akira
Surgical Treatment of Rectal Prolapse in the Laparoscopic Era; A Review of the Literature
title Surgical Treatment of Rectal Prolapse in the Laparoscopic Era; A Review of the Literature
title_full Surgical Treatment of Rectal Prolapse in the Laparoscopic Era; A Review of the Literature
title_fullStr Surgical Treatment of Rectal Prolapse in the Laparoscopic Era; A Review of the Literature
title_full_unstemmed Surgical Treatment of Rectal Prolapse in the Laparoscopic Era; A Review of the Literature
title_short Surgical Treatment of Rectal Prolapse in the Laparoscopic Era; A Review of the Literature
title_sort surgical treatment of rectal prolapse in the laparoscopic era; a review of the literature
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7390613/
https://www.ncbi.nlm.nih.gov/pubmed/32743110
http://dx.doi.org/10.23922/jarc.2019-035
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