COMPARATIVE EVALUATION OF VENTRAL MESH RECTOPEXY AND LAPAROSCOPIC POSTERIOR RECTOPEXY IN THE TREATMENT OF FULL-THICKNESS RECTAL PROLAPSE
Keywords:
Keywords: rectal prolapse, ventral mesh rectopexy, laparoscopic rectopexy, posterior rectopexy, pelvic floor, minimally invasive surgery.Abstract
Abstract: Background: Rectal prolapse remains a challenging condition in colorectal surgery, with multiple surgical options and no universal standard. Minimally invasive abdominal procedures, particularly ventral mesh rectopexy (VMR) and laparoscopic posterior rectopexy (LPR), are increasingly considered optimal approaches due to low recurrence and favorable functional outcomes.
Objective: To compare early and long-term outcomes of ventral mesh rectopexy and laparoscopic posterior rectopexy without resection in patients with full-thickness rectal prolapse.
Methods: A prospective comparative study included 54 patients with complete rectal prolapse. Patients were divided into two groups: Group A (n=27) underwent ventral mesh rectopexy, Group B (n=27) underwent laparoscopic posterior rectopexy without resection. Outcomes assessed included operative time, blood loss, postoperative complications, length of hospital stay, recurrence rate, and functional outcomes (constipation and fecal incontinence scores) at 12 and 24 months.
Results: VMR demonstrated significantly better improvement in constipation and incontinence scores, with lower recurrence rates compared to posterior rectopexy. Posterior rectopexy showed shorter operative time but higher incidence of postoperative constipation.
Conclusion: Ventral mesh rectopexy provides superior functional outcomes and lower recurrence rates compared to laparoscopic posterior rectopexy, particularly in patients with associated pelvic floor dysfunction.
References
1. Koimtzis G, Stefanopoulos L, Geropoulos G, Chalklin CG, Karniadakis I, Alawad AA, et al.
Mesh Rectopexy or Resection Rectopexy for Rectal Prolapse; Is There a Gold Standard Method: A Systematic Review, Meta‑Analysis and Trial Sequential Analysis. J Clin Med. 2024;13(5):1363.
doi:10.3390/jcm13051363
2. Elbarmelgi MY, Shafik AA, Badee SF, Refaie OM, Tamer M.
Levatorplasty’s Role in Rectal Prolapse Management for Patients With Wide Pelvic Hiatus: Cohort Study. BMC Surg. 2025;25:19.
doi:10.1186/s12893-024-02693-9
3. Schabl L, Hull T, Erozkan K, et al.
Ventral Mesh Rectopexy for Recurrent Rectal Prolapse After Altemeier Perineal Proctosigmoidectomy: Feasibility and Outcomes. Langenbeck’s Arch Surg. 2024;409:49.
doi:10.1007/s00423-024-03227-w
4. Herrle F, Sandra‑Petrescu F, Rothenhoefer S, et al.
Laparoscopic Resection Rectopexy vs Delorme’s Procedure in Full‑Thickness Rectal Prolapse — DELORES‑RCT. Ann Surg. 2025; in press.
5. Tou S, Brown SR, Malik AI, Nelson RL.
Surgery for complete rectal prolapse in adults. Cochrane Database Syst Rev. 2008;4:CD001758.
6. Bordeianou L, Paquette I, Johnson E, et al.
Clinical Practice Guidelines for the Treatment of Rectal Prolapse. Dis Colon Rectum. 2017;60(11):1121–1131.
7. Mayberry J, King PM, Phillips RK.
A European view on laparoscopic ventral rectopexy. Colorectal Dis. 2020;22(4):469–480.
8. O’Grady G, Welch JP, Schraut WH, et al.
Rectal Prolapse: Operative Strategies in Adults. World J Surg. 2021;45(11):3252–3260.
9. Senapati A, Phillips RKS, Küçükdurmaz F.
Pelvic floor and rectal prolapse: implications for choice of surgical approach. Br J Surg. 2022;109(6):612–624.
10. Clinical Guidelines – Rectal Prolapse (ministry/health authority recommendations).
