Laparoscopic Rectopexy for Rectal Prolapse to Reduce Surgical-Site Infections and Length of Stay

Background Rectal prolapse is commonly seen in patients with significant co-morbidities. Multiple approaches have been described, including the use of laparoscopy. The purpose of this study was to determine if laparoscopic approaches for repair of rectal prolapse are associated with less short-term...

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Bibliographic Details
Published in:World journal of surgery 2013-05, Vol.37 (5), p.1110-1114
Main Authors: Magruder, J. Trent, Efron, Jonathan E., Wick, Elizabeth C., Gearhart, Susan L.
Format: Article
Language:English
Subjects:
Abdominal Surgery
Adolescent
Adult
Aged
Aged, 80 and over
Cardiac Surgery
Databases, Factual
Female
General Surgery
Humans
Laparoscopic Rectopexy
Laparoscopic Sigmoid Resection
Laparoscopy
Length of Stay - statistics & numerical data
Logistic Models
Male
Medicine
Medicine & Public Health
Middle Aged
Rectal Prolapse
Rectal Prolapse - surgery
Rectum - surgery
Resection Rectopexy
Retrospective Studies
Risk Factors
Sigmoid Resection
Surgery
Surgical Wound Infection - etiology
Surgical Wound Infection - prevention & control
Thoracic Surgery
Treatment Outcome
Vascular Surgery
Young Adult
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Summary:Background Rectal prolapse is commonly seen in patients with significant co-morbidities. Multiple approaches have been described, including the use of laparoscopy. The purpose of this study was to determine if laparoscopic approaches for repair of rectal prolapse are associated with less short-term morbidity than open approaches. Methods The American College of Surgeons National Surgical Quality Improvement Program database was queried for patients who underwent laparoscopic or open rectopexy (R) or sigmoid resection and rectopexy (SR + R) between 2005 and 2008. Co-morbidities analyzed included diabetes, body mass index, chronic obstructive pulmonary disease, hypertension, cardiac (history of congestive heart failure, myocardial infarction, peripheral vascular disease, previous percutaneous cardiac intervention or surgery), and neurologic disorder (history of transient ischemic attack or cerebrovascular accident). Postoperative complications analyzed included surgical-site infections (SSIs), pneumonia, reintubation, pulmonary embolus, stroke, myocardial infarction, and sepsis. The χ 2 or t test/ANOVA were used to assess significance for categoric and continuous variables, respectively. Logistic regression analysis was used to determine risk factors for morbidity after rectal prolapse repair. Results Altogether, 685 patients underwent surgical treatment of rectal prolapse. Most patients underwent open SR + R (open: 247 SR + R, 193 R; laparoscopic: 161 SR + R, 84 R). All patients had similar co-morbidity profiles. Patients undergoing laparoscopic R were significantly older (mean age 61.4 years) than those in the other three groups ( p  = 0.04). Operating time ranged from 128 min (open R) to 185 min (laparoscopic SR + R; p  
ISSN:0364-2313
1432-2323
DOI:10.1007/s00268-013-1943-7