Our Summary

This research paper discusses a study comparing two surgical methods used to treat rectal prolapse (a condition where the rectum, the last part of the large intestine, slips outside the anus). The traditional method is an open surgery called transabdominal rectopexy, while the newer method is a minimally invasive procedure called laparoscopic rectopexy.

The authors examined data from 65 patients who had either laparoscopic (50 patients) or open (15 patients) rectopexy between 2008 and 2015. They compared several aspects of the surgeries, including how long they took, how long patients stayed in the hospital, complications, blood loss, and the effect on incontinence (loss of bowel or bladder control).

The results showed that the laparoscopic surgery took longer on average (127 minutes compared to 83.6 minutes for open surgery). However, patients who had laparoscopic surgery had minimal blood loss and a shorter hospital stay (4.2 days compared to 7.2 days for open surgery patients). Both types of surgery improved rectal prolapse and incontinence, with no recurrences of rectal prolapse reported.

In conclusion, the authors suggest that laparoscopic rectopexy is a safe and effective treatment for rectal prolapse, especially for older patients. It helps them get back on their feet quicker after surgery and reduces their time in the hospital.

FAQs

  1. What are the two surgical methods for treating rectal prolapse discussed in the study?
  2. How does the recovery time and complications compare between laparoscopic and open rectopexy?
  3. Is laparoscopic rectopexy considered a safe and effective treatment for rectal prolapse according to the authors?

Doctor’s Tip

One helpful tip a doctor might give a patient about rectal prolapse surgery is to discuss the option of laparoscopic rectopexy with them. This minimally invasive procedure has been shown to have benefits such as minimal blood loss, shorter hospital stay, and effective treatment of rectal prolapse and incontinence. Patients should ask their doctor about the different surgical methods available and consider the advantages and disadvantages of each before making a decision.

Suitable For

Patients who are typically recommended rectal prolapse surgery are those who have tried conservative treatments such as dietary changes, pelvic floor exercises, and medications without success. These patients may have symptoms such as chronic constipation, fecal incontinence, pain during bowel movements, or the protrusion of the rectum through the anus.

Additionally, patients who are in good overall health and are able to tolerate surgery are good candidates for rectal prolapse surgery. Older patients, in particular, may benefit from laparoscopic rectopexy due to its shorter hospital stay and quicker recovery time.

Overall, the decision to recommend rectal prolapse surgery is made on a case-by-case basis by a healthcare provider after a thorough evaluation of the patient’s symptoms, medical history, and overall health.

Timeline

Before rectal prolapse surgery, a patient may experience symptoms such as rectal bleeding, discomfort, a feeling of a bulge or protrusion from the anus, and difficulty with bowel movements. They may undergo diagnostic tests such as a physical examination, colonoscopy, or imaging studies to confirm the diagnosis.

After the surgery, the patient will likely experience some pain and discomfort at the surgical site. They may also have restrictions on activities such as heavy lifting or strenuous exercise for a period of time. It is important for the patient to follow their doctor’s post-operative instructions, including taking prescribed medications, attending follow-up appointments, and gradually resuming normal activities.

Over time, the patient should see improvement in their symptoms of rectal prolapse, such as reduced bleeding and discomfort. With proper care and rehabilitation, they should be able to regain normal bowel function and quality of life.

What to Ask Your Doctor

Some questions a patient should ask their doctor about rectal prolapse surgery include:

  1. What are the benefits of laparoscopic rectopexy compared to open surgery for treating rectal prolapse?
  2. What are the potential risks and complications associated with both types of surgery?
  3. How long is the recovery period for each type of surgery, and what can I expect during the recovery process?
  4. Will I experience any changes in bowel or bladder function after the surgery?
  5. Are there any alternative treatment options for rectal prolapse that I should consider?
  6. How many of these surgeries have you performed, and what is your success rate with this procedure?
  7. What is the likelihood of the rectal prolapse recurring after surgery?
  8. Will I need any additional treatments or follow-up care after the surgery?
  9. How long will I need to stay in the hospital after the surgery, and when can I resume normal activities?
  10. Are there any specific dietary or lifestyle changes I should make before or after the surgery to aid in my recovery?

Reference

Authors: Hashida H, Sato M, Kumata Y, Mizumoto M, Kondo M, Kobayashi H, Yamamoto T, Terajima H, Kaihara S. Journal: Int J Surg. 2019 Dec;72:109-114. doi: 10.1016/j.ijsu.2019.10.024. Epub 2019 Nov 6. PMID: 31704417