Short-term outcomes of laparoscopic ventral rectopexy for obstructed defecation in patients with overt pelvic structural abnormalities

doi:10.3877/cma.j.issn.1674-6899.2017.04.004

Abstract

Abstract:

Objective

To evaluate the safety and efficacy of laparoscopic ventral rectopexy(LVR)for Obstructed Defecation(OD)in patients with overt pelvic abnormalities.

Methods

19 consecutive of OD patients underwent LVR procedure. Overt pelvic abnormalities were confirmed by MRI defecography examination in all the patients. Data of surgery was recorded. Functional outcomes were assessed by Cleveland Clinical Constipation score(CCCS)and patient assessment of constipation quality of life (PAC-QoL).

Results

19 enrolled patients (mean age 58 years old) with a mean follow-up of 15 (6-24) months; No severe complication was recorded during operation and follow up and no mesh-related complication was reported. At the end of the follow up, 78.9%(15/19)of the patients reported symptom relief of OD, the result of CCCS improved significantly (decrease from 17.2 to 10.0, P<0.01 ), The improvements of PAC-QoL were achieved in all the 4 subscales, of which physical discomfort , worries and concerns and satisfaction showed statistical significance (P<0.05).

Conclusions

Laparoscopic Ventral Rectopexy appears a safe and effective procedure for obstructed defecation with various forms rectal prolapse abnormalities in short term follow up.

Key words: Laparoscopic surgery, Surgical mesh, Obstructive defecation, Quality of life, Pelvis, Functional outcomes

Zhe Cui, GuangYao Ye. Short-term outcomes of laparoscopic ventral rectopexy for obstructed defecation in patients with overt pelvic structural abnormalities[J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2017, 10(04): 203-206.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhqjwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-6899.2017.04.004

https://zhqjwkzz.cma-cmc.com.cn/EN/Y2017/V10/I04/203

Figures/Tables 1

References 20

1	Ellis CN, Essani R. Treatment of obstructed defecation[J]. Clin Colon Rectal Surg, 2012, 25(1): 24-33.
2	Vlasta , Podzemny , Lorenzo , et al. Management of obstructed defecation[J]. World Journal of Gastroenterology, 2015, 21(4): 1053-1060.
3	Antonio , Bove , Massimo , et al. Consensus statement AIGO/SICCR diagnosis and treatment of chronic constipation and obstructed defecation (PartⅡ：Treatment)[J]. World Journal of Gastroenterology Wjg, 2012, 18(36): 4994-5013.
4	D′Hoore A, Penninckx F. Long-term outcome of laparoscopic ventral rectopexy for total rectal prolapse[J]. British Journal of Surgery, 2004, 91(11): 1500-1505.
5	Mercer-Jones MA, D'Hoore A, Dixon AR, et al. Consensus on ventral rectopexy: report of a panel of experts[J]. Colorectal Disease the Official Journal of the Association of Coloproctology of Great Britain & Ireland, 2014, 16(9): 82-88.
6	Gouvas N, Georgiou PA, Agalianos C, et al. Ventral colporectopexy for overt rectal prolapse and obstructed defaecation syndrome: a systematic review[J]. Colorectal Disease the Official Journal of the Association of Coloproctology of Great Britain & Ireland, 2015, 17(2): 34-46.
7	Collinson R, Cunningham CH, Lindsey I. Rectal intussusception and unexplained faecal incontinence: findings of a proctographic study[J]. Colorectal Disease, 2009, 11(1): 77-83.
8	Comiter CV, Vasavada SP, Barbaric ZL, et al. Grading pelvic prolapse and pelvic floor relaxation using dynamic magnetic resonance imaging[J]. Urology, 1999, 54(3): 454-457.
9	Collinson R, Wijffels N, Cunningham C, et al. Laparoscopic ventral rectopexy for internal rectal prolapse: short-term functional results[J]. Colorectal Disease, 2010, 12(2): 97-104.
10	D′Hoore A, Penninckx F. Laparoscopic ventral recto(colpo)pexy for rectal prolapse: surgical technique and outcome for 109 patients[J]. Surgical Endoscopy, 2006, 20(12): 1919-1923.
11	Agachan F, Chen T, Pfeifer J, et al. A constipation scoring system to simplify evaluation and management of constipated patients[J]. Diseases of the Colon & Rectum, 1996, 39(6): 681-685.
12	Marquis P, De LLC, Dubois D, et al. Development and validation of the patient assessment of constipation quality of life questionnaire[J]. Scandinavian Journal of Gastroenterology, 2005, 40(5): 540-551.
13	Gagliardi G, Pescatori M, Altomare DF, et al. Results, outcome predictors, and complications after stapled transanal rectal resection for obstructed defecation[J]. Diseases of the Colon & Rectum, 2008, 51(2): 186-195.
14	Formijne Jonkers HA, Draaisma WA, Wexner SD, et al. Evaluation and surgical treatment of rectal prolapse: an international survey[J]. Colorectal Disease the Official Journal of the Association of Coloproctology of Great Britain & Ireland, 2013, 15(1): 115-119.
15	Pescatori M, Spyrou M, Pulvirenti D'Urso A. A prospective evaluation of occult disorders in obstructed defecation using the 'iceberg diagram’[J]. Colorectal Disease, 2007, 9(5): 452-456.
16	Van Iersel JJ, Paulides TJ, Verheijen PM, et al. Current status of laparoscopic and robotic ventral mesh rectopexy for external and internal rectal prolapse[J]. World Journal of Gastroenterology, 2016, 22(21): 4977-4987.
17	Tsunoda A, Takahashi T, Ohta T, et al. Quality of life after laparoscopic ventral rectopexy[J]. Colorectal Disease the Official Journal of the Association of Coloproctology of Great Britain & Ireland, 2015, 18(8): 301-310.
18	Consten EC, Van Iersel JJ, Verheijen PM, et al. Long-term outcome after laparoscopic ventral mesh rectopexy: an observational study of 919 consecutive patients[J]. Annals of Surgery, 2015, 262(5): 742-747.
19	Evans C, Stevenson AR, Sileri P, et al. A multicenter collaboration to assess the safety of laparoscopic ventral rectopexy[J]. Diseases of the Colon & Rectum, 2015, 58(8): 799-807.
20	Smart NJ, Pathak S, Boorman P, et al. Synthetic or biological mesh use in laparoscopic ventral mesh rectopexy-a systematic review[J]. Colorectal Disease the Official Journal of the Association of Coloproctology of Great Britain & Ireland, 2013, 15(6): 650-654.

功能性结果		术前	术后	P值^*
CCCS(分)		17.2 ± 1.1	10.0 ± 1.3	0.0025
PAC-QoL(分)		?	?	?
?	躯体不适	2.6 ± 0.2	1.3 ± 0.3	0.0133
?	心理不适	2.1 ± 0.2	1.0 ± 0.2	0.0743
?	焦虑和关切	2.5 ± 0.2	1.4 ± 0.3	0.0330
?	满意度	3.4 ± 0.2	1.8 ± 0.3	0.0042

功能性结果		术前	术后	P值^*
CCCS(分)		17.2 ± 1.1	10.0 ± 1.3	0.0025
PAC-QoL(分)		?	?	?
?	躯体不适	2.6 ± 0.2	1.3 ± 0.3	0.0133
?	心理不适	2.1 ± 0.2	1.0 ± 0.2	0.0743
?	焦虑和关切	2.5 ± 0.2	1.4 ± 0.3	0.0330
?	满意度	3.4 ± 0.2	1.8 ± 0.3	0.0042

[1]	Xuefeng Ma, Xiaofeng Liu, Xiang Xiao, Chunzhu Gong, Xiaobo Yi. Effect of total hip arthroplasty on postoperative ankylosing spondylitis involving unilateral hip joint [J]. Chinese Journal of Joint Surgery(Electronic Edition), 2021, 15(04): 496-498.
[2]	Lunyang Hu, Baoli Wang, Wenjia Hou, Wanfang Zhou, Jing Shi, Yong Jiang, Guosheng Wu, Yu Sun, Zhaofan Xia. Quality of life and its influencing factors in patients with small area burns after discharge [J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2021, 16(03): 216-223.
[3]	Amanula Fuerduosi, Peng Qin, Shangzhi Ma, jie Wang, Hongliang Diao. A cohort study of laparoscopic pylorus and vagus nerve-preserving gastrectomy for patients with early gastric cancer [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2021, 15(02): 170-173.
[4]	Haidan Ye, Lishan Zhang, Xinchun Luo. Sleep quality and its influencing factors in liver transplant recipients [J]. Chinese Journal of Transplantation(Electronic Edition), 2021, 15(03): 152-155.
[5]	Lei Yu, Kouzhun Wei, Zhigang Liu, Guangbin Chen, Zhi Wang. Comparison on clinical effects of laparoscopic inguinal hernioplasty with different surgical approaches [J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2021, 15(04): 361-365.
[6]	Yidi Ma, Sumei Wang. Application status and prospect from hernia surgical mesh in the treatment of pelvic organ prolapse [J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2021, 15(04): 325-328.
[7]	Wei Zhao, Xiaowen Yue. Study on perioperative nursing strategy of laparoscopic uterine suspension combined with anterior and posterior vaginal wall repair for severe uterine prolapse combined with posterior vaginal wall intestinal hernia [J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2021, 15(03): 267-271.
[8]	Juhua Duan, Damin Chen, Yunxia Sun, Dian Yin, Yunxiu Sun, Guimei Liu. Prospective controlled study for quality of life in elderly patients with inguinal hernia treated by Lichtenstein procedure [J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2021, 15(02): 169-172.
[9]	Junxi Xiang, Kui Yang, Guanghui Wang, Long Li, Yuelang Zhang, Yinying Wu, Wei Yang, Junjun She, Qingguang Liu, Yingmin Yao, Cheng Guo. Laparoscopic surgery for colon cancer liver metastasis and pelvic metastasis: a case report [J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2021, 14(04): 241-244.
[10]	Sirao Qu, Manman Zhao, Quanhong Li, Fang Li, Jingjing Ma, Yinan Zhang, Siran Jing, Jianli Sun. Comparison of clinical efficacy of gasless vaginal natural orififice transluminal endoscopic surgery and traditional laparoscopy surgery for ovarian cyst [J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2021, 14(04): 217-220.
[11]	Peng Hu, Wenquan Liang, Kecheng Zhang, Hongqing Xi, Jianxin Cui, Lin Chen. Short-term and quality of life outcomes of laparoscopy-assisted versus totally laparoscopic distal gastrectomy for gastric cancer: a single-center retrospective cohort study [J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2021, 14(03): 141-148.
[12]	Xiangxing Kong, Yeting Hu, Kefeng Ding, Jianwei Wang. A case of pelvic huge solitary fibrous tumor with rectum and retroperitoneum invasion [J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2021, 10(03): 324-326.
[13]	Shichao Meng, Dou Wu, Enzhe Zhao, Zhenwu Gao, Qiang Liu. Research on novel sacroiliac screw in the treatment of posterior pelvic ring fracture and auxiliary placement techniques [J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2021, 07(03): 187-192.
[14]	Meixiang Hua, Junliang Deng, Liang Li. Effect of long-term sertraline intervention on the prognosis of elderly patients with acute ischemic stroke [J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2021, 11(02): 101-104.
[15]	Xin Lan, Chenglin Piao, Fengduo An, Mingkun Tan, Zhenduo Si, Wei Wu, Na Zhao, Jianjun Leng. Short-term outcomes of three-dimensional vs two-dimensional laparoscopic hepatectomy for hepatocellular carcinoma [J]. Chinese Journal of Clinicians(Electronic Edition), 2021, 15(05): 327-330.

Please choose a citation manager

Content to export