RecruitingNot ApplicableNCT06559085

Posterior Versus Lateral Laparoscopic Mesh Rectopexy for the Management of Complete Rectal Prolapse


Sponsor

Assiut University

Enrollment

30 participants

Start Date

Aug 15, 2024

Study Type

INTERVENTIONAL

Conditions

Summary

Aim of the study is to evaluate the outcomes of two different methods of mesh placement during laparoscopic rectopexy for the management of complete rectal prolapse lateral versus posterior mesh rectopexy


Eligibility

Min Age: 18 YearsMax Age: 75 Years

Inclusion Criteria3

  • Age from 18 to 70 years.
  • Both sexes.
  • Patients with complete rectal prolapse.

Exclusion Criteria3

  • Unfit for surgery
  • Impaired coagulation profile
  • Contraindication of laparoscopy

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Interventions

PROCEDURELaproscopic posterior mesh rectopexy (Wells or LPMR)

After complete rectal mobilization, a mesh is inserted between the sacrum and the posterior rectum, sutured into the rectum, and fixed to the promontory. The mortality rates ranged from 0% to 1.2%, and recurrence rates ranged from 0% to 11% There was an overall improvement in continence (74%-100%), with conflicting results regarding constipation. New-onset constipation in 5% to 44% of patients was reported

PROCEDURELaparoscopic lateral mesh rectopexy (Orr-Loygue)

This procedure involves complete mobilization of the rectum with two mesh strips sutured laterally to the rectal wall on both sides, and they were suspended to the promontory. There are several studies on this procedure using a laparoscopic approach. Lechaux et al. performed laparoscopic Orr-Loygue rectopexy in 35 patients. Incontinence improved in 27% of patients, and constipation improved in 19% but worsened in 27%. The recurrence rate was 3% (1/35) after a mean follow-up of 36 months. A study on 46 patients with laparoscopic Orr-Loygue procedure with posterior mobilization found a significant reduction in incontinence score after 1 year, but there were no changes in the use of laxatives. The recurrence rate was 4% after a median follow-up of 1.5 years


Locations(1)

Assiut university

Asyut, Egypt

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NCT06559085