The effect of laparoscopic rectopexy with Douglas pouch repair combined with procedure for prolapse and hemorrhoids (PPH) based on pelvic anatomy for rectal internal mucosal prolapse

Objective To evaluate the effect of laparoscopic rectopexy with Douglas pouch repair combined with procedure for prolapse and hemorrhoids (PPH) based on pelvic anatomy for rectal internal mucosal prolapse. Methods From Mar 2009 to Sep 2011. 37 patients (group A) received laparoscopic rectopexy with Douglas pouch repair based on pelvic anatomy, and group B (n=41) received laparoscopic rectopexy with Douglas pouch repair combined with PPH. Constipation level, degree of internal prolapse, relapse and postoperative complications were assessed in 5 years after operation. Results 5 years after operation, the relief of constipation and the improvement of internal prolapse in group B were better than in group A [(-0.4±0.9)cm vs.(-1.0±1.1)cm, t=2.370, P=0.020]. The recurrence rate in group B was statistically lower than that in group A (10% vs. 30%, χ2=4.995, P=0.025). Grade Ⅰ to Grade Ⅲ complications between the two groups was not statistically different (11% vs. 12%, χ2=0.037, P=0.848). Conclusions The effect of laparoscopic rectopexy with Douglas pouch repair combined with PPH based on pelvic anatomy for rectal internal mucosal prolapse was superior to laparoscopic rectopexy with Douglas pouch repair. Key words: Rectal prolapse; Ligament; Reconstructive surgical procedures; Rectopexy; Procedure for prolapse and hemorrhoids