Open vs. laparoscopic surgery for rectal prolapse: a case-controlled study assessing short-term outcome.
This study was undertaken to evaluate the efficacy and safety of laparoscopic repair for rectal prolapse. A case-control study was undertaken. The case group consisted of a consecutive series of patients who underwent laparoscopic repair for rectal prolapse between February 1993 and June 2000. The control group underwent open prolapse repair between October 1987 and January 2000. There were 53 patients in each group. The groups were matched according to operation type, gender, and age. Median operative time was longer in the case group than in the control group (resection rectopexy 210 vs. 117 minutes, rectopexy 127.5 vs. 72 minutes, respectively). Median postoperative hospital stay was shorter in the case group than in the control group (resection rectopexy 5 vs. 7 days, rectopexy 4.5 vs. 7 days, respectively). Median intraoperative bleeding was minor in the case group (resection rectopexy 35 vs. 300 ml, rectopexy 15 vs. 100 ml, respectively). Mortality (0 vs. 4 percent), complications (23 vs. 30 percent), late complications (4 vs. 13 percent), and the rate of recurrent prolapse (6 vs. 13 percent) did not differ significantly between the groups. Laparoscopic repair for rectal prolapse is technically feasible and can be performed with mortality and morbidity rates comparable to those of the conventional technique. The main advantages of the laparoscopic approach appear to be a shorter hospital stay and lessened intraoperative blood loss. Recurrence rate is not increased in the short term.