caa a22 4500 475779592 CHVBK 20180406123640.0 cr unu---uuuuu 170329e20000701xx s 000 0 eng 10.1007/s004640000017 doi (NATIONALLICENCE)springer-10.1007/s004640000017 Laparoscopic repair of rectal prolapse [Elektronische Daten] A prospective study evaluating surgical outcome and changes in symptoms and bowel function [I. H. Kellokumpu, J. Vironen, T. Scheinin] Background: There have been few large series that have focused on the feasibility of the laparoscopic approach for rectal prolapse. This single-institution study prospectively examines the surgical outcome and changes in symptoms and bowel function following the laparoscopic repair of rectal prolapse. Methods: In a selected group of 34 patients (total prolapse, 28; intussusception, six), 17 patients underwent laparoscopic-assisted resection rectopexy and 17 patients received a laparoscopic sutured rectopexy. Preoperative and postoperative evaluation at 3, 6, and 12 months included assessment of the severity of anal incontinence, constipation, changes in constipation-related symptoms, and colonic transit time. Results: Median operation time was 255 min (range, 180-360) in the resection rectopexy group and 150 min (range, 90-295) in the rectopexy alone group. Median postoperative hospital stay was 5 days (range, 3-15) and median time off work was 14 days (range, 12-21) in both groups. There were no deaths. Postoperative morbidity was 24%. Incontinence improved significantly regardless of which method was used. The main determinant of constipation was excessive straining at defecation. Constipation was cured in 70% of the patients in the rectopexy group and 64% in the resection rectopexy group. Symptoms of difficult evacuation improved, but the changes were significant only after resection rectopexy. Two patients (7%) developed recurrent total prolapse during a median follow-up of 2 years (range 12-60 months). Conclusions: Laparoscopic-sutured rectopexy and laparoscopic-assisted resection rectopexy are feasible and carry an acceptable morbidity rate. They eliminate prolapse and cure incontinence in the great majority of patients. Constipation and symptoms of difficult evacuation are alleviated. Springer-Verlag New York Inc., 2000 Key words: Rectal prolapse — Laparoscopy — Rectopexy — Sigmoidectomy — Bowel function nationallicence Kellokumpu I. H. Fourth Department of Surgery, Surgical Hospital, University of Helsinki, Kasarmikatu 11-13, FIN- 00130 Helsinki, Finland, Finland aut Vironen J. Fourth Department of Surgery, Surgical Hospital, University of Helsinki, Kasarmikatu 11-13, FIN- 00130 Helsinki, Finland, Finland aut Scheinin T. Fourth Department of Surgery, Surgical Hospital, University of Helsinki, Kasarmikatu 11-13, FIN- 00130 Helsinki, Finland, Finland aut Surgical Endoscopy Springer-Verlag 14/7(2000-07-01), 634-640 0930-2794 14:7<634 2000 14 464 https://doi.org/10.1007/s004640000017 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s004640000017 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kellokumpu I. H. Fourth Department of Surgery, Surgical Hospital, University of Helsinki, Kasarmikatu 11-13, FIN- 00130 Helsinki, Finland, Finland aut NATIONALLICENCE 700 1- Vironen J. Fourth Department of Surgery, Surgical Hospital, University of Helsinki, Kasarmikatu 11-13, FIN- 00130 Helsinki, Finland, Finland aut NATIONALLICENCE 700 1- Scheinin T. Fourth Department of Surgery, Surgical Hospital, University of Helsinki, Kasarmikatu 11-13, FIN- 00130 Helsinki, Finland, Finland aut NATIONALLICENCE 773 0- Surgical Endoscopy Springer-Verlag 14/7(2000-07-01), 634-640 0930-2794 14:7<634 2000 14 464 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer