Posterior Orr-Loygue rectopexy in rectal prolapse.

Study aim: The aim of this retrospective study was to report the results of posterior Orr-Loygue rectopexy in 55 patients operated on for rectal prola pse. Patients and method. From 1986 to 1997, 114 patients were operated on for r ectal prolapse and 55 had an Orr-Loygue operation. There were 47 women and 8 men (mean age: 55 years). Twenty-five patients (45%) had fecal incontinen ce, 26 (47%) described preoperative 'constipation'. The procedure was perfo rmed under general anesthesia, through laparotomy in 51 patients, through l aparoscopy in 4 patients. Resection of sigmoid colon was associated to rect opexy in four patients. Results: Mortality rate was 0 and morbidity rate 12%. Mean hospital stay du ration was 13.5 days. Mean follow-up was 63 months and at the end of the st udy, four patients (7%) had recurrence, 5/25 patients had still incontinenc e; 55% of the patients had unchanged postoperative bowel function, 22% desc ribed improvement (including the four patients with resection-rectopexy) bu t 38% (21/55) suffered from postoperative 'constipation'. The rate of 'cons tipation' induced or majored by rectopexy was 22% but the functional troubl e described appeared often complex. Conclusion: Posterior Orr-Loygue rectopexy is the operation recommended for patients in good general condition, especially if fecal incontinence is as sociated. In the course of the procedure, preservation of pelvic nerves and hypogastric plexus, and positioning of the strips not too tight between th e anterolateral rectal walls and promontory must be emphasized. Posterior O rr-Loygue rectopexy is contraindicated when general anesthesia is too risky and when bowel dysfunction and/or rectal exoneration dysfunction are prese nt. (C) 2000 Editions scientifiques et medicales Elsevier SAS.