BN 69_Does Laparoscopic Resection Rectopexy

Transcription

BN 69_Does Laparoscopic Resection Rectopexy
Does Laparoscopic Resection Rectopexy Has Lower
Recurrence Rate than Open and Robot-Assisted Rectopexy? A
systematic Review and Meta-analysis.
Background: Laparoscopy has been applied to treatment of rectal and colon diseases allowing an additional
and less invasive therapeutic method in the successful treatment of rectal prolapse. The available research
tends to favour laparoscopy over the conventional abdominal procedures for treating rectal prolapse. Thus it
is worthy to investigate whether laparoscopic resection rectopexy has lower recurrence rates than open
rectopexy and robot-assisted rectopexy for the treatment of rectal prolapsed.
Aims: To compare between the recurrence rate of laparoscopic resection rectopexy and other surgical
procedures including open rectopexy (OR) and robot-assisted rectopexy (RR) for the treatment of rectal
prolapsed among adults population.
Methods: Systematic reviews of the current literature were performed from January 2003 to August
2013 by using the Wiley Online Library, PubMed Central PMC, CINHAL, Cochrane Library, Biomed
Central, Medline, and Science Direct.
Results: Three papers have been identified in this current Meta-analysis. The results showed that the
laparoscopic rectopexy has a higher recurrence rate 3.60 times than the other procedures (OR or RR).
Conclusions: This study showed that laparoscopic rectopexy is feasible and efficient for the treatment
of full thickness rectal prolapse in the adult population; however, the recurrence rate in the laparoscopic
approach higher than with open and Robot- Assisted procedures. The recurrence rate was higher in
male patients than female patients. Though, no study compares the recurrence rate among subgroups
of laparoscopic rectopexy.
Dr.Mahmood M Hardan, Dr.Susan Plummer, Prof.Henk Wegstapel
Canterbury Christ Church University
References:
1-De Hoog,Dominique E. N. M. & Heemskerk J, Fred H. Nieman M , Wim G. Gemert, Cor G. M. I. Baeten & Nicole D. Bouvy; Recurrence and functional results after open versus conventional laparoscopic versus robotassisted laparoscopic rectopexy for rectal prolapse: a case–control study; Int J Colorectal Dis. 2009 October; 24(10): 1201–1206 :
2- De Oliveira O, Stein S, Trencheva K, Sonoda T, Milsom J & Lee J, Comparative Outcomes of Elderly Patients Undergoing Altemeier Procedure versus Laparoscopic Rectopexy for Rectal Prolapse Asian J Endosc Surg,
2009, ISSN 1758-5902
3- Solmon M , Young C , Eyers A and Roberts A. Randomised Clinical Trail of Laparoscopic versus Open Abdominal Rectopexy for Rectal Prolapse,BJS,2002,89, 35-39.