Short-term outcome of suture rectopexy in children with rectal prolapse: laparoscopic versus posterior sagittal approach

Morsi, Ahmed H.; Elshahat, Wael; Kassem, Hesham; Gobran, Tarek A.; Tantawy, Ismail M.; Waly, Amira H.

doi:10.4103/ejs.ejs_130_18

Short-term outcome of suture rectopexy in children with rectal prolapse: laparoscopic versus posterior sagittal approach

Authors

Abstract

Context
Innumerable surgical options addressing persistent rectal prolapse are available. This study compared the short-term outcome of laparoscopic suture rectopexy (LSR) with posterior sagittal rectopexy (PSR).
Patients and methods
A prospective randomized study was carried out on patients requiring rectal prolapse surgery. Patients were randomly allocated into LSR and PSR groups. Patients with neurological/musculoskeletal deficits, lower gastrointestinal tract anomalies and those with previous pelvic or perineal surgeries were excluded.
Results
A total of 66 patients, who had suture rectopexy done, were followed up for a minimum of 6 months following surgery. There were 33 LSR and 33 PSR. The mean duration of symptoms was 19 months (range: 6 months to 7.5 years). The mean age at operation was 5.9 years (range: 2.5–12 years), with a slight female predominance (54.5%). The mean operative time was 87.2 and 51.3 min for LSR and PSR, respectively. The mean postoperative hospital stay was 41.18 and 31.87 h for PSR and LSR, respectively. LSR had better Manchester Scar Scale scores compared with PSR (mean: 6.45 and 10.09, respectively). LSR patients resumed unrestricted activities earlier than those of PSR (mean: 9.84 and 15.15 days, respectively). Both groups showed comparable improvements in bowel functions and quality of life. Complications were a transient partial recurrence in one LSR patient (3.1%) and two wound infections in PSR group (6.2%). There was one conversion to laparotomy in LSR group (3.1%).
Conclusion
Both techniques seemed equally effective in eliminating rectal prolapse. Without longer operative times and conversion to laparotomy, LSR would have been absolutely superior to PSR.

Keywords