ABDOMINAL RESECTION RECTOPEXY WITH PELVIC FLOOR REPAIR VERSUS PERINEAL RECTOSIGMOIDECTOMY AND PELVIC FLOOR REPAIR FOR FULL-THICKNESS RECTALPROLAPSE

A randomized trial was performed to compare abdominal resection rectop exy and pelvic floor repair (n = 10) with perineal rectosigmoidectomy and pelvic floor repair (n = 10) in elderly female patients with full- thickness rectal prolapse and faecal incontinence. There were no recur rences of full-thickness prolapse following resection rectopexy but on e after rectosigmoidectomy. Continence to liquid and solid stool was a chieved in nine patients, with faecal soiling reported in only two, af ter resection rectopexy and in eight, with soiling in six, following r ectosigmoidectomy. The median (range) frequency of defaecation was onl y 1 (1-3) per day following resection rectopexy compared with 3 (1-6) per day after rectosigmoidectomy. There was an increase in the mean(s. d.) maximum resting pressure after resection rectopexy (19.3(15.28) cm H(2)O) compared with a reduction following rectosigmoidectomy (-3.4(13 .75) cmH(2)O) (P = 0.003). Mean(s.d.) compliance was also greater afte r resection rectopexy than following rectosigmoidectomy (3.9(0.75) ver sus 2.2(0.78) ml/cmH(2)O, P<0.001). Abdominal resection rectopexy give s better functional and physiological results than perineal rectosigmo idectomy.