Portal de investigación
Comparative study of laparoscopic ventral mesh rectopexy versus perineal stapler resection for external full-thickness rectal prolapse in elderly patients: enhanced outcomes and reduced recurrence rates-a retrospective cohort study.
Fecha de publicación:
Fecha Ahead of Print:
Autores de IIS La Fe
Participantes ajenos a IIS La Fe
- Habeeb TAAM
- Podda M
- Chiaretti M
- Kechagias A
- Kalmoush AE
- Mustafa FM
- Nassar MS
- Labib MF
- Teama SRA
- Elshafey MH
- Elbelkasi H
- Alsaad MIA
- Sallam AM
- Ashour H
- Mansour MI
- Mostafa A
- Elshahidy TM
- Yehia AM
- Rushdy T
- Ramadan A
- Hamed AEM
- Yassin MA
- Metwalli AM
Abstract
BACKGROUND: In elderly patients with external full-thickness rectal prolapse (EFTRP), the exact differences in postoperative recurrence and functional outcomes between laparoscopic ventral mesh rectopexy (LVMR) and perineal stapler resection (PSR) have not yet been investigated. METHODS: We conducted a retrospective multicenter study on 330 elderly patients divided into LVMR group (n = 250) and PSR (n = 80) from April 2012 to April 2019. Patients were evaluated before and after surgery by Wexner incontinence scale, Altomare constipation scale, and patient satisfaction questionnaire. The primary outcomes were incidence and risk factors for EFTRP recurrence. Secondary outcomes were postoperative incontinence, constipation, and patient satisfaction. RESULTS: LVMR was associated with fewer postoperative complications (p < 0.001), lower prolapse recurrence (p < 0.001), lower Wexner incontinence score (p = 0.03), and lower Altomare's score (p = 0.047). Furthermore, LVMR demonstrated a significantly higher surgery-recurrence interval (p < 0.001), incontinence improvement (p = 0.019), and patient satisfaction (p < 0.001) than PSR. Three and 13 patients developed new symptoms in LVMR and PSR, respectively. The predictors for prolapse recurrence were LVMR (associated with 93% risk reduction of recurrence, OR 0.067, 95% CI 0.03-0.347, p = 0.001), symptom duration (prolonged duration was associated with an increased risk of recurrence, OR 1.131, 95% CI 1.036-1.236, p = 0.006), and length of prolapse (increased length was associated with a high recurrence risk (OR = 1.407, 95% CI = 1.197-1.655, p < 0.001). CONCLUSIONS: LVMR is safe for EFTRP treatment in elderly patients with low recurrence, and improved postoperative functional outcomes. TRIAL REGISTRATION: Clinical Trial.gov (NCT05915936), retrospectively registered on June 14, 2023.
© 2024. The Author(s).
Datos de la publicación
- ISSN/ISSNe:
- 1123-6337, 1128-045X
- Tipo:
- Article
- Páginas:
- 48-48
- PubMed:
- 38619626
- Factor de Impacto:
- 0,809 SCImago ℠
- Cuartil:
- Q1 SCImago ℠
TECHNIQUES IN COLOPROCTOLOGY SPRINGER-VERLAG ITALIA SRL
Documentos
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Filiaciones
Keywords
- Elderly; Functional outcomes; Laparoscopic ventral mesh rectopexy; Perineal stapler resection; Rectal prolapse; Recurrence
Proyectos y Estudios Clínicos
ESTUDIO CLINICO MULTICENTRICO EN FASE III ALEATORIZADO, DE DOBLE CIEGO, DE RELACION DOSIS- RESPUESTA, DE CONTROL PLACEBO Y EN GRUPOS PARALELOS PARA DETERMINAR LA EFICACIA Y TOLERABILIDAD DE LOS GRANULOS DE MESALAZINA VS PLACEBO PARA PREVENIR LA REAPARICIO N DE DIVERTICULITIS.
Investigador Principal: JUAN ANTONIO ORTUÑO CORTES
SAG-51DIV
COMPLICACIONES DE HERIDA QUIRÚRGICA EN PACIENTES INTERVENIDOS DE EVENTRACIÓN. ESTUDIO PILOTO COMPARATIVO DE APÓSITO QUIRÚRGICO CONVENCIONAL FRENTE A TERAPIA DE PRESIÓN NEGATIVA DE UN SOLO USO.
Investigador Principal: ASCENSIÓN FRANCO BERNAL
PICO