Introduction The surgical approach to recurrent full-thickness rectal prolapse is more complicated than for primary full thickness rectal prolapse. However, it has not been reported that redo rectopexy for recurrent full thickness rectal prolapse is as safe and feasible as primary rectopexy. This study evaluated the safety and efficacy of redo rectopexy with and without resection for recurrent full thickness rectal prolapse.
Method After IRB approval, 144 consecutive patients [138 females; mean age 57 (range, 16–83) years] with primary [n = 112; 108 females, mean age 56 (range, 16–80) years] or recurrent [n = 32; 30 females, mean age 58 (29–83) years] rectal prolapse who underwent rectopexy with and without resection between May 2000 and April 2014 were identified from a prospective database. Perioperative outcomes and reoperation rate due to recurrence were compared between the two groups.
Results Both groups had comparable demographics, BMI, ASA scores, type of surgical approach, and comorbidities. Patients with primary rectopexy had a higher percentage of resected colon (60.7%) than did those with redo rectopexy (28.1%; p = 0.001). Patients had open (75 vs. 25), hand-assisted (3 vs. 1) and laparoscopic (34 vs. 6) surgery in the primary vs. redo rectopexy groups, respectively (p = 0.213). Intraoperative blood loss and length of postoperative stay were similar in both groups. The most common complication was ileus (n = 15). There was no significant difference in the postoperative complication rate (primary rectopexy 30.6% vs. redo rectopexy 37.5%; p = 0.521). The reoperation rate due to recurrence was significantly higher in redo rectopexy vs. primary rectopexy (12.5% vs. 1.8%; p = 0.022). The mean interval from primary surgery to reoperation for recurrence was 17.0 (range, 2.5–40.5) months for the redo rectopexy group and 46.8 (range, 30.0–63.7) months for the primary rectopexy. Functional data were not available.
Conclusion Redo rectopexy with and without resection can be performed as safely as primary rectopexy in patients with full-thickness rectal prolapse. However, the re-reoperation rate due to recurrence of rectal prolapse is higher in redo rectopexy.
Disclosure of interest None Declared.
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