Outcome analysis of elderly patients undergoing laparoscopic resection rectopexy for rectal prolapse

Tilman Laubert*, Franz G. Bader, Markus Kleemann, Hamed Esnaashari, Ralf Bouchard, Philipp Hildebrand, Erik Schlöricke, Hans Peter Bruch, Uwe J. Roblick

*Corresponding author for this work
18 Citations (Scopus)

Abstract

Purpose For treatment of rectal prolapse, abdominal approaches are generally offered to younger patients, whereas perineal, less invasive procedures are considered more beneficial in the elderly. The aim of this study was to analyze whether laparoscopic resection rectopexy (LRR) is suitable for older patients. Patients/Methods Patients who received LRR for rectal prolapse were selected from a prospective laparoscopic colorectal surgery database. Perioperative and long-term outcome were compared between patients <75 years old (group A) and ≥75 years old (group B). Results Of 154 patients, 111 were in group A and 43 in group B. There was one conversion that occurred in group B. Overall mortality rate was 1.3% (n02). Both patients were in group B (group B, 4.7%; p=0.079). Differences in major and minor complications between the groups were not significant. Rates of improvement for incontinence were 62.7% (group A) and 66.7% (group B; p=0.716); for constipation, the rates were 78.9% (group A) and 73.3% (group B; p=0.832). All recurrences occurred in group A (n010; overall, 10.3%; group A, 13%). After exclusion of patients who had previously received perineal prolapse surgery, recurrence rate was 3.3% overall (group A, 4.3%). Conclusions This study supports the benefits of LRR for rectal prolapse in elderly patients. Age per se is not a contraindication for LRR. Elderly patients encounter complications slightly more frequently (although not statistically significant) than younger patients. Therefore, a very careful patient selection in the elderly is of paramount importance. However, the long-term outcome does not seem to differ between younger and elderly patients.

Original languageEnglish
JournalInternational Journal of Colorectal Disease
Volume27
Issue number6
Pages (from-to)789-795
Number of pages7
ISSN0179-1958
DOIs
Publication statusPublished - 01.06.2012

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