Long-term outcomes of surgical management of rectal prolapse

Zi Qin Ng, Michael Levitt, Patrick Tan, Gregory Makin, Cameron Platell

Research output: Contribution to journalArticle

Abstract

Background: Various surgical options for rectal prolapse are available but none have been shown to be clearly superior. The aims of this study were to investigate the long-term recurrence rate of a variety of surgical approaches, their associated morbidities and the types of reoperation used to treat recurrence. Methods: A retrospective analysis was performed of all cases of rectal prolapse surgery within one colorectal surgical unit between January 2000 and June 2017. Abdominal approaches consisted of rectopexy (RP) and resection rectopexy (RRP); perineal approaches included perineal rectosigmoidectomy (PR) and Delorme's repair (DR). Complications were graded according to the Clavien–Dindo classification. The median follow-up was 4.5 years (interquartile range 1.5–10.1, maximum 16.5). Statistical analysis was performed using Kaplan–Meier to determine recurrence rates. Results: A total of 157 patients were included in the study. The numbers for each procedure were: DR (n = 55), RRP (n = 44), RP (n = 38) and PR (n = 20). The majority were females (94%). The perineal group were significantly older than the abdominal group (80 versus 67 years, P = 0.0001). At 5 years, the recurrence rates were 52%, 30%, 5% and 3% for DR, PR, RP and RRP, respectively. Morbidity was highest in PR (20%) followed by RRP (18%), RP (16%) and DR (7%) (n.s.). The overall morbidity rates for perineal group and abdominal group were 10.7% and 17.1%, respectively (n.s.). Conclusion: Abdominal approaches have a significantly lower recurrence rate at 5 years but tend to be associated with higher morbidity.

Original languageEnglish
Pages (from-to)E231-E235
Number of pages5
JournalANZ Journal of Surgery
Volume89
Issue number6
Early online date13 May 2019
DOIs
Publication statusPublished - Jun 2019

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Rectal Prolapse
Recurrence
Morbidity
Reoperation

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Ng, Zi Qin ; Levitt, Michael ; Tan, Patrick ; Makin, Gregory ; Platell, Cameron. / Long-term outcomes of surgical management of rectal prolapse. In: ANZ Journal of Surgery. 2019 ; Vol. 89, No. 6. pp. E231-E235.
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title = "Long-term outcomes of surgical management of rectal prolapse",
abstract = "Background: Various surgical options for rectal prolapse are available but none have been shown to be clearly superior. The aims of this study were to investigate the long-term recurrence rate of a variety of surgical approaches, their associated morbidities and the types of reoperation used to treat recurrence. Methods: A retrospective analysis was performed of all cases of rectal prolapse surgery within one colorectal surgical unit between January 2000 and June 2017. Abdominal approaches consisted of rectopexy (RP) and resection rectopexy (RRP); perineal approaches included perineal rectosigmoidectomy (PR) and Delorme's repair (DR). Complications were graded according to the Clavien–Dindo classification. The median follow-up was 4.5 years (interquartile range 1.5–10.1, maximum 16.5). Statistical analysis was performed using Kaplan–Meier to determine recurrence rates. Results: A total of 157 patients were included in the study. The numbers for each procedure were: DR (n = 55), RRP (n = 44), RP (n = 38) and PR (n = 20). The majority were females (94{\%}). The perineal group were significantly older than the abdominal group (80 versus 67 years, P = 0.0001). At 5 years, the recurrence rates were 52{\%}, 30{\%}, 5{\%} and 3{\%} for DR, PR, RP and RRP, respectively. Morbidity was highest in PR (20{\%}) followed by RRP (18{\%}), RP (16{\%}) and DR (7{\%}) (n.s.). The overall morbidity rates for perineal group and abdominal group were 10.7{\%} and 17.1{\%}, respectively (n.s.). Conclusion: Abdominal approaches have a significantly lower recurrence rate at 5 years but tend to be associated with higher morbidity.",
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Long-term outcomes of surgical management of rectal prolapse. / Ng, Zi Qin; Levitt, Michael; Tan, Patrick; Makin, Gregory; Platell, Cameron.

In: ANZ Journal of Surgery, Vol. 89, No. 6, 06.2019, p. E231-E235.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Long-term outcomes of surgical management of rectal prolapse

AU - Ng, Zi Qin

AU - Levitt, Michael

AU - Tan, Patrick

AU - Makin, Gregory

AU - Platell, Cameron

PY - 2019/6

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N2 - Background: Various surgical options for rectal prolapse are available but none have been shown to be clearly superior. The aims of this study were to investigate the long-term recurrence rate of a variety of surgical approaches, their associated morbidities and the types of reoperation used to treat recurrence. Methods: A retrospective analysis was performed of all cases of rectal prolapse surgery within one colorectal surgical unit between January 2000 and June 2017. Abdominal approaches consisted of rectopexy (RP) and resection rectopexy (RRP); perineal approaches included perineal rectosigmoidectomy (PR) and Delorme's repair (DR). Complications were graded according to the Clavien–Dindo classification. The median follow-up was 4.5 years (interquartile range 1.5–10.1, maximum 16.5). Statistical analysis was performed using Kaplan–Meier to determine recurrence rates. Results: A total of 157 patients were included in the study. The numbers for each procedure were: DR (n = 55), RRP (n = 44), RP (n = 38) and PR (n = 20). The majority were females (94%). The perineal group were significantly older than the abdominal group (80 versus 67 years, P = 0.0001). At 5 years, the recurrence rates were 52%, 30%, 5% and 3% for DR, PR, RP and RRP, respectively. Morbidity was highest in PR (20%) followed by RRP (18%), RP (16%) and DR (7%) (n.s.). The overall morbidity rates for perineal group and abdominal group were 10.7% and 17.1%, respectively (n.s.). Conclusion: Abdominal approaches have a significantly lower recurrence rate at 5 years but tend to be associated with higher morbidity.

AB - Background: Various surgical options for rectal prolapse are available but none have been shown to be clearly superior. The aims of this study were to investigate the long-term recurrence rate of a variety of surgical approaches, their associated morbidities and the types of reoperation used to treat recurrence. Methods: A retrospective analysis was performed of all cases of rectal prolapse surgery within one colorectal surgical unit between January 2000 and June 2017. Abdominal approaches consisted of rectopexy (RP) and resection rectopexy (RRP); perineal approaches included perineal rectosigmoidectomy (PR) and Delorme's repair (DR). Complications were graded according to the Clavien–Dindo classification. The median follow-up was 4.5 years (interquartile range 1.5–10.1, maximum 16.5). Statistical analysis was performed using Kaplan–Meier to determine recurrence rates. Results: A total of 157 patients were included in the study. The numbers for each procedure were: DR (n = 55), RRP (n = 44), RP (n = 38) and PR (n = 20). The majority were females (94%). The perineal group were significantly older than the abdominal group (80 versus 67 years, P = 0.0001). At 5 years, the recurrence rates were 52%, 30%, 5% and 3% for DR, PR, RP and RRP, respectively. Morbidity was highest in PR (20%) followed by RRP (18%), RP (16%) and DR (7%) (n.s.). The overall morbidity rates for perineal group and abdominal group were 10.7% and 17.1%, respectively (n.s.). Conclusion: Abdominal approaches have a significantly lower recurrence rate at 5 years but tend to be associated with higher morbidity.

KW - complication

KW - prolapse

KW - rectum

KW - recurrence

KW - surgery

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DO - 10.1111/ans.15264

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JO - Australian New Zealand Journal of Surgery

JF - Australian New Zealand Journal of Surgery

SN - 1445-1433

IS - 6

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