ABSTRACT
Objective:To compare the clinical efficacy of laparoscopic integral pelvic floor/ligament repair (IPFLR) combined with a procedure for prolapse and hemorrhoids (PPH) and that laparoscopic IPFLR alone in the treatment of internal rectal prolapse (IRP) in women.Methods:Patients were divided into groups A in which 63 patients undergoing laparoscopic IPFLR alone, and group B of 67 patients reciving laparoscopic IPFLR combined with PPH. The degree of internal rectal prolapse (DIRP), Wexner constipation scale (WCS) score, Wexner incontinence scale (WIS) score, and Gastrointestinal Quality of Life Index (GIQLI) score were compared between these two groups and in each group those before surgery and 6 months, 2 years, and 5 years after surgery.Results:The number of bowel movements , DIRP, WCS score, WIS score, and GIQLI score before surgery were not significantly different between the two groups (all P>0.05). The DIRP, WCS score, WIS score, and GIQLI score in each group 6 months, 2 years, and 5 years after surgery in both two groups were significantly better than those before surgery (all P<0.001). The DIRP, WCS score, WIS score, and GIQLI score in group B were significantly better than those in group A at 6 months, 2 years, and 5 years after surgery (all P<0.05) except DIRP at 2 years after surgery (all P<0.05). There was a significant difference in the recurrence rate of IRP between the two groups when evaluated at 5 years after surgery ( P=0.001). Conclusions:Integral theory-guided laparoscopic IPFLR combined with PPH has a higher cure rate and a better clinical efficacy than laparoscopic IPFLR alone.
ABSTRACT
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 taparoscopic 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％,x2 =4.995,P =0.025).Grade Ⅰ to Grade Ⅲ complications between the two groups was not statistically different (11％ vs.12％,x2 =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.