Quality of life after laparoscopic ventral rectopexy

• Published in: Colorectal disease Vol. 18; no. 8; pp. O301 - O310
• Main Authors: Tsunoda, A., Takahashi, T., Ohta, T., Kusanagi, H.
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01-08-2016
• Subjects: Adult; Aged; Aged, 80 and over; Constipation - etiology; Constipation - surgery; Defecography; Digestive System Surgical Procedures - methods; DNA-Binding Proteins; External rectal prolapse; Fecal Incontinence - etiology; Fecal Incontinence - surgery; Female; functional results; Fungal Proteins; Humans; Intussusception - complications; Intussusception - surgery; laparoscopic ventral rectopexy; Male; Middle Aged; Quality of Life; Rectal Diseases - complications; Rectal Diseases - surgery; Rectal Prolapse - complications; Rectal Prolapse - surgery; rectoanal intussusception; Treatment Outcome; External rectal prolapse; rectoanal intussusception; quality of life; functional results; laparoscopic ventral rectopexy
• ISSN: 1462-8910; 1463-1318
• DOI: 10.1111/codi.13247

Aim
This study evaluated continence, constipation and quality of life (QOL) before and after laparoscopic ventral rectopexy (LVR)
Method
Between February 2012 and July 2014, patients who underwent LVR for external rectal prolapse (ERP) and/or rectoanal intussusception (RAI) were prospectively included. A standard questionnaire including the Fecal Incontinence Severity Index (FISI), the Constipation Scoring System (CSS) and QOL instruments (Short‐Form 36 Health Survey, Fecal Incontinence QOL scale, Patient Assessment of Constipation‐QOL) were administered before and after operation. Psychiatric patients and those with dementia were excluded from the study. Defaecography was performed 6 months postoperatively.
Results
Fifty‐nine patients were included in the study period and 44 (19 with ERP, 25 with RAI) completed the follow‐up questionnaire and were reviewed after a median of 26 (range 12–42) months. There was no recurrent ERP. Postoperative defaecography showed new‐onset RAI in 6 and persistent RAI in 1. One year after surgery, incontinence was improved in 30/39 patients (77%) and constipation in 19/32 (59%). The FISI scores reduced between preoperative status and 1 year after surgery [32 (13–61) vs 11 (0–33), P < 0.0001]. The CSS scores also reduced [preoperative 12 (5–18) vs 1 year 5 (1–12), P < 0.0001]. Compared with the preoperative scores, almost all of the scale scores on the three kinds of QOL instruments significantly improved over time. The presence of new‐onset or persistent RAI did not have an adverse effect on the improvement of QOL.
Conclusion
LVR improves both generic and symptom‐specific QOL with good functional results.