Abstract
Objective
Ventral rectopexy is a validated treatment for rectal prolapse with a low morbidity rate but a risk of intrarectal mesh migration. The purpose of this study was to report the results of local transanal mesh excision for intrarectal mesh migration after ventral rectopexy.
Methods
Between January 2004 and March 2011, 312 patients underwent laparoscopic ventral rectopexy in two hospitals. Six patients were treated for intrarectal mesh migration.
Results
Delay between ventral rectopexy and the onset of symptoms was 53 months (4–124 months). All patients have symptoms. Imaging revealed a pelvic abscess in two cases. Intrarectal mesh migration was confirmed by anorectoscopy or clinical examination. Five patients were only treated by local transanal partial mesh excision, and one required a colostomy. Morbidity and mortality were zero. The median hospitalization time was 5 days (3–8 days). After a median postoperative follow-up period of 9 months (1–40 months), one recurrence was observed 2 months after surgery.
Conclusion
Local transanal mesh excision for intrarectal mesh migration after laparoscopic ventral rectopexy is a feasible conservative treatment. This simple treatment produced a cure of the pelvic inflammation and closure of the fistula without compromising a more aggressive secondary treatment which was not necessary in our series.
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Abbreviations
- EUS:
-
Endorectal ultrasound
- MRI:
-
Magnetic resonance imaging
- RP:
-
Rectal prolapse
- VR:
-
Ventral rectopexy
References
Karulf RE, Madoff RD, Goldberg SM (2001) Rectal prolapse. Curr Probl Surg 38:771–832
Samaranayake CB, Luo C, Plank AW et al (2010) Systematic review on ventral rectopexy for rectal prolapse and intussusception. Colorectal Dis 12:504–512
D'Hoore A, Cadoni R, Penninckx F (2004) Long-term outcome of laparoscopic ventral rectopexy for total rectal prolapse. Br J Surg 91:1500–1505
Boons P, Collinson R, Cunningham C, Lindsey I (2010) Laparoscopic ventral rectopexy for external rectal prolapse improves constipation and avoids de novo constipation. Colorectal Dis 12:526–532
Marchal F, Bresler L, Ayav A et al (2005) Long-term results of Delorme's procedure and Orr-Loygue rectopexy to treat complete rectal prolapse. Dis Colon Rectum 48:1785–1790
Portier G, Iovino F, Lazorthes F (2006) Surgery for rectal prolapse: Orr-Loygue ventral rectopexy with limited dissection prevents postoperative-induced constipation without increasing recurrence. Dis Colon Rectum 49:1136–1140
Feiner B, Jelovsek JE, Maher C (2009) Efficacy and safety of transvaginal mesh kits in the treatment of prolapse of the vaginal apex: a systematic review. BJOG 116:15–24
Ouaissi M, Cresti S, Giger U et al (2010) Management of rectovaginal fistulas after prosthetic reinforcement treatment for pelvic organ prolapse. World J Gastroenterol 16:3011–3015
Caliskan C, Denizli A, Makay O et al (2009) Experimental comparison of meshes for rectal prolapse surgery. Eur Surg Res 43:310–314
Jakus SM, Shapiro A, Hall CD (2008) Biologic and synthetic graft use in pelvic surgery: a review. Obstet Gynecol Surv 63:253–266
Dwyer PL, O'Reilly BA (2004) Transvaginal repair of anterior and posterior compartment prolapse with Atrium polypropylene mesh. BJOG 111:831–836
Hernandez P, Targarona EM, Balague C et al (2008) Laparoscopic treatment of rectal prolapse. Cir Esp 84:318–322
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Tranchart, H., Valverde, A., Goasguen, N. et al. Conservative treatment of intrarectal mesh migration after ventral laparoscopic rectopexy for rectal prolapse. Int J Colorectal Dis 28, 1563–1566 (2013). https://doi.org/10.1007/s00384-013-1740-7
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DOI: https://doi.org/10.1007/s00384-013-1740-7