Objective : This prospective study was designed to evaluate the role of laparoscopic ventral mesh rectopexy In mangement of rectal prolapse .
Patient and method : The study comprised 30 patient ; 22 (73.3)female and 8 (26.7) Males with mean age of 43.4 ±13.4. All patients underwent laparoscopic ventral Mesh rectopexy (LVMR) for rectal prolapse were evaluated in the present study by Perioperative outcomes, improvement in bowel dysfunction or appearance of new complications were documented from the hospital records maintained prospectively.18 (60%) patient presented with fecal incontinence and 12 (40%) patient presented with obstructed defecation .
Results: Surgical outcome included intraoperative (IO), postoperative (PO) and follow-up data. Functional outcome was assessed at 6-m and 12-m PO and compared versus preoperative evaluation for severity of fecal incontinence (FI) using Vaizey score, frequency and severity of constipation using Cleveland Clinic Constipation (CCC) score and impact of FI on patient's quality of life (QOL) using the Fecal incontinence Quality .of life scale (FIQL) score . (11)
All patients passed smooth uneventful operative and immediate postoperative course. No patient required conversion to laparotomy. operative time was range 120-240 min and amount of IO blood loss was range: 60-120 ml. Laparoscopic surgery provided its usual advantages concerning low PO pain score, and early ambulation, oral intake, and hospital discharge.. All patients showed significant functional improvement manifested as a significant decrease of Vaizey FI and CCC scores with a significant increase of FIOL score at 6-m PO and these scorings were progressively improved till 12-m PO.
Conclusion: LVMRP is a safe procedure for management of CRP within reasonable operative time and with minimal immediate PO morbidities. LVMR provided significant improvement of CRP-associated FI and constipation and its impact on patients QOL. LVMR is associated with low frequency of PO recurrence throughout 12-m follow-up.
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