LAPAROSCOPIC-ASSISTED VS OPEN RESECTION - RECTOPEXY OFFERS EXCELLENT RESULTS

PURPOSE: Anterior resection +/- rectopexy effectively manages full-thi ckness rectal prolapse; however, morbidity is approximately 15 percent mainly because of the laparotomy wound. There has been no comparison of laparoscopic with laparotomy approaches to the repair of this disor der. The purpose of this paper is to compare an age/sex-matched series of laparoscopic-assisted (n = 8) with laparotomy (n = 10) resections/ rectopexies. METHODS: A retrospective case review of laparoscopic-assi sted (n = 8) vs. laparotomy (n = 10) resections/rectopexies from May 1 989 to September 1993 was performed. Data collected included age, gend er, technique, operative blood loss, operative time, length of bowel r esected, length of hospital stay, return of bowel function, oral intak e, and postoperative complications. RESULTS: No significant difference was noted in age, sex, length of bowel resected, mortality, significa nt morbidity, or recurrence (mean follow-up, 27.1 +/- 4.4 months) in e ither group. Estimated blood loss for the laparotomy group was greater than for the laparoscopic group (285.0 +/- 35.0 vs. 184.4 +/- 31.0 ml ). Operative time was greater for the laparoscopic group (177.1 +/- 23 .0 vs. 86.5 +/- 8.6 min). Length of stay (95.0 +/- 16.7 vs. 183.5 +/- 8.9 hours), time to passage of flatus (3.9 +/- 1.1 vs. 2.8 +/- 1.9 day s), and resumption of oral intake (4.5 +/- 0.7 vs. 2.8 +/- 1.9 days) o ccurred earlier for the laparoscopic group. CONCLUSION: Therefore, lap aroscopic-assisted resection/rectopexy effectively treats rectal prola pse without the morbidity of the laparotomy wound and significantly sh ortens hospitalization for this benign disease.