Abdominal rectopexy for rectal prolapse. Meta-analysis of literature

Laparoscopic rectopexy to treat full-thickness rectal prolapse has proven short-term benefits, but there are little long-term follow-up and functional outcome data available. Using meta-analytical techniques, this study was designed to evaluate long term results of open and laparoscopic abdominal procedures to treat full-thickness rectal prolapse in adults. Methods: A literature review was performed using the National Library of Medicine’s Pubmed Database; all articles reporting on abdominal rectopexy with a follow up longer than 16 months were considered. The primary end point was recurrence of rectal prolapse and the secondary end points were incontinence and constipation improvement. A random effect model was used to aggregate the studies reporting these outcomes, and heterogeneity was assessed. Results: Eight comparative studies, consisting of a total of 467 patients (275 open and 192 laparoscopic) were included. Analysis of data suggested that there is no significant difference in recurrence, incontinence and constipation improvement between laparoscopic abdominal rectopexy and open abdominal rectopexy. Conclusions: Laparoscopic abdominal rectopexy is a safe and feasible procedure, which may compare equally with the open technique with regards to recurrence, incontinence and constipation. However large-scale randomized trials, with comparative, strong methodology are still needed to find out outcome measures accurately.