Laparoskopická rektopexe
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INTRODUCTION: Rektopexis is an effective treatment method of rectal prolapses. Our retrospective study assessed the laparoscopic rectopexis results. METHODOLOGY: From 01-01-2003 to 31-11-2005, 10 patients were indicated for the procedure of laparoscopic retropexis. A "Vypro" mesh (Johnson&Johnson) was used to suspend the rectum. We fix it to the sacrum and to the rectum with an anchor (Eanchr, Johnson&Johnson). The follow-up examinations were conducted 2-30 months after the procedure. We assessed mortality rates, morbidity rates, the prolaps relapses incidence rates, obstipation incidence rates. RESULTS: The laparoscopic procedure was completed in 9 patients. In one case, we converted. The mortality and serious postoperative morbidity rate was 0%. The mean duration of hospitalization was 7 days. During the follow-up, no patient relapsed. One female patient complained of mild postoperative obstipation, which, however, did not require surgical revision. CONCLUSION: Laparoscopic rectopexis is a modern, safe and effective method of the prolaps of the rectum treatment.
- MeSH
- laparoskopie * metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- prolaps rekta chirurgie MeSH
- rektum chirurgie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
INTRODUCTION: Obstructive defecation syndrome (ODS) presents a common medical problem, which can be caused by various pelvic disorders; multiple disorders are frequently diagnosed. At the present, a high number of corrective techniques are available via various surgical approaches. Laparoscopic resection rectopexy is a minimally invasive technique, which comprises redundant sigmoidal resection with rectal mobilisation and fixation. METHODS: The aim of this paper was to evaluate the safety and effectiveness of laparoscopic resection rectopexy in the treatment of patients with ODS. The evaluation was performed via our own patients data analysis and via literature search focused on laparoscopic resection rectopexy. RESULTS: In total, 12 patients with ODS undergoing laparoscopic resection rectopexy in University Hospital Ostrava during the study period (2012-2015) were included in the study. In our study group, mean age was 64.5 years and mean BMI was 21.9; the group included 11 women (91.6%). ODS was caused by multiple pelvic disorders in all patients. Dolichosigmoideum and rectal prolapse (internal or external) were diagnosed in all included patients. On top of that, rectocoele and enterocoele were diagnosed in several patients. Laparoscopic resection rectopexy was performed without intraoperative complications; mean operative time was 144 minutes. Mean postoperative length of hospital stay was 7 days. Postoperative 30-day morbidity was 16.6%. All postoperative complications were classified as grade II according to Clavien-Dindo classification. Mean preoperative Wexner score was 23.6 points; mean score 6 months after the surgery was 11.3 points. Significant improvement in ODS symptoms was noted in 58.3% of patients, and a slight improvement in 16.6% of patients; resection rectopexy provided no clinical effect in 25% of patients. CONCLUSION: It is fundamental to carefully select those patients with ODS who could possibly profit from the surgery. Our results, in accordance with published data, suggest that laparoscopic resection rectopexy is a valuable surgical technique in the treatment of patients with ODS caused by multiple pelvic disorders. KEY WORDS: obstructive defecation syndrome - constipation - resection rectopexy - operative techniques - pelvic floor disorders.
- MeSH
- chirurgie trávicího traktu metody MeSH
- colon sigmoideum chirurgie MeSH
- defekace MeSH
- délka operace MeSH
- délka pobytu MeSH
- hernie komplikace MeSH
- laparoskopie metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- onemocnění dna pánevního chirurgie MeSH
- operace kýly MeSH
- pooperační komplikace MeSH
- prolaps rekta chirurgie MeSH
- rektokéla komplikace chirurgie MeSH
- rektum chirurgie MeSH
- senioři MeSH
- střevní obstrukce chirurgie MeSH
- výsledek terapie MeSH
- zácpa chirurgie MeSH
- zákroky plastické chirurgie metody MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH