ArticleSurgical endoscopy2015
Surgical treatments for rectal prolapse: how does a perineal approach compare in the laparoscopic era?
Article in Surgical endoscopy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
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Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 26 citations in OpenAlex.
- Management of patients with rectal prolapse: the 2017 Dutch guidelines.Techniques in coloproctology · 2018Guideline
- What have we learned in minimally invasive colorectal surgery from NSQIP and NIS large databases? A systematic review.International journal of colorectal disease · 2018Pooled it
- Outcomes of minimally invasive approaches to rectopexy: laparoscopic versus robotic.Journal of robotic surgery · 2025Article
- Comparative Outcomes of Transabdominal and Transperineal Approaches for Full-Thickness Rectal Prolapse Repair: A Fourteen-Year Retrospective Study.Gastroenterology research · 2025Article
- Rectal Prolapse Surgery: Balancing Effectiveness and Safety in Abdominal and Perineal Approaches.Cureus · 2024Review
- Validity of task-specific metrics for assessment in perineal proctectomy.Surgical endoscopy · 2024Article
- Transanal rectopexy for external rectal prolapse.Annals of coloproctology · 2022Article
- Preoperative Advance Care Planning for Older Adults Undergoing Major Abdominal Surgery.The American journal of hospice & palliative care · 2022Article
- Comparison of Delorme-Thiersch Operation Outcomes in Men and Women With Rectal Prolapse.Annals of coloproctology · 2019Article
- Altemeier's procedure for complete rectal prolapse; outcome and function in 43 consecutive female patients.BMC surgery · 2019Article
- Laparoscopic surgery: A qualified systematic review.World journal of methodology · 2015Article
- Delorme's Procedure for Complete Rectal Prolapse: A Study of Recurrence Patterns in the Long Term.Surgery research and practice · 2015Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients with rectal prolapse often have significant comorbidities that lead surgeons to select a perineal resection for treatment despite a reported higher recurrence rate over abdominal approaches. There is a lack of data to support this practice in the laparoscopic era. The objective of this study was to evaluate if risk-adjusted morbidity of perineal surgery for rectal prolapse is actually lower than laparoscopic surgery.
designA retrospective review of the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database as performed for patients undergoing surgical treatment of rectal prolapse between 2005 and 2011. Outcomes were analyzed according to procedure-type: laparoscopic rectopexy (LR), laparoscopic resection/rectopexy (LRR), open rectopexy (OR), open resection/rectopexy (ORR), and perineal resection (PR). A multivariate logistic regression was used to compare risk-adjusted morbidity and mortality between each procedure. Main outcome measures were 30-day morbidity and mortality.
resultsAmong 3,254 cases sampled, a laparoscopic approach was used in 22 %, an open abdominal approach in 30 %, and PR in 48 %. Patients undergoing PR were older (76) and had a higher ASA (3) compared to laparoscopic (58, 2) and open abdominal procedures (58, 2). Risk-adjusted mortality could not be assessed due to a low overall incidence of mortality (0.01 %). Overall morbidity was 9.3 %. ORR was associated with a higher risk-adjusted morbidity compared to PR (OR: 1.89 CI (1.19-2.99), p = 0.03). There were no significant differences in risk-adjusted morbidity found between LR and LRR compared to PR (OR 0.44 CI (0.19-1.03), p = 0.18; OR 1.55 CI (0.86-2.77), p = 0.18). Laparoscopic cases averaged 27 min longer than open cases (p < 0.001).
conclusionLaparoscopic rectal prolapse surgery has comparable morbidity and mortality to perineal surgery. A randomized trial is indicated to validate these findings and to assess recurrence rates and functional outcomes.
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