Journal article
Adverse obstetric history is not a risk factor for poor outcome after ventral rectopexy for obstructive defaecation syndrome.
- Kremel D Department of Colorectal Surgery, Western General Hospital, Edinburgh, UK.
- Riss S Department of Surgery, Medical University of Vienna, Vienna, Austria.
- Müller C Department of Surgery, Medical University of Vienna, Vienna, Austria.
- von Strauss M Department of Surgery, University Hospital Basel, Basel, Switzerland.
- Winstanley C Department of Colorectal Surgery, Western General Hospital, Edinburgh, UK.
- Winstanley J Department of Colorectal Surgery, Western General Hospital, Edinburgh, UK.
- Potter M Department of Colorectal Surgery, Western General Hospital, Edinburgh, UK.
- Paterson H Department of Colorectal Surgery, Western General Hospital, Edinburgh, UK.
- Collie M Department of Colorectal Surgery, Western General Hospital, Edinburgh, UK.
- 2018-09-02
Published in:
- Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland. - 2018
Laparoscopic ventral mesh rectopexy
faecal incontinence
obstetric histroy
obstructive defecation syndrome
Adult
Aged
Aged, 80 and over
Constipation
Delivery, Obstetric
Digestive System Surgical Procedures
Female
Humans
Intestinal Obstruction
Intussusception
Middle Aged
Postoperative Complications
Pregnancy
Rectocele
Retrospective Studies
Risk Factors
Surgical Mesh
Treatment Outcome
English
AIM
Ventral rectopexy (VR) has gained popularity in the management of obstructive defaecation syndrome (ODS) due to a symptomatic rectocele ± intussusception. Data on the efficacy and safety of VR are variable and there are few predictors of successful outcome. This study aimed to examine whether or not an adverse obstetric history influenced the functional outcome following VR for ODS.
METHOD
This was a retrospective study of a cohort of 76 consecutive patients who had undergone VR for ODS at a tertiary referral centre between 2012 and 2015. Patients were followed up by telephone questionnaire. The obstetric history and pre- and postoperative symptoms of ODS and faecal incontinence (FI) were obtained from telephone interviews.
RESULTS
In this cohort, symptoms of ODS were significantly improved by surgery, with 56% of patients showing a reduction of symptoms of 50% or more (P < 0.001). Subgroup analysis demonstrated that a lower body mass index (BMI; 24.4 vs 27.3 kg/m2 ; P < 0.05) and shorter duration of symptoms (7 vs 10 years; P < 0.05) led to a better outcome. VR had no effect on FI. Obstetric factors such as foetal weight, instrumental delivery, episiotomy, perineal tear and total number of deliveries did not influence outcomes.
CONCLUSION
Patients with a less straightforward obstetric history can be reassured that this should not adversely influence the functional outcome after VR for ODS. Colorectal surgeons who offer this surgery should warn patients with an elevated BMI or with longstanding symptoms that the operation may be less successful than for those with a lower BMI or shorter duration of symptoms.
Ventral rectopexy (VR) has gained popularity in the management of obstructive defaecation syndrome (ODS) due to a symptomatic rectocele ± intussusception. Data on the efficacy and safety of VR are variable and there are few predictors of successful outcome. This study aimed to examine whether or not an adverse obstetric history influenced the functional outcome following VR for ODS.
METHOD
This was a retrospective study of a cohort of 76 consecutive patients who had undergone VR for ODS at a tertiary referral centre between 2012 and 2015. Patients were followed up by telephone questionnaire. The obstetric history and pre- and postoperative symptoms of ODS and faecal incontinence (FI) were obtained from telephone interviews.
RESULTS
In this cohort, symptoms of ODS were significantly improved by surgery, with 56% of patients showing a reduction of symptoms of 50% or more (P < 0.001). Subgroup analysis demonstrated that a lower body mass index (BMI; 24.4 vs 27.3 kg/m2 ; P < 0.05) and shorter duration of symptoms (7 vs 10 years; P < 0.05) led to a better outcome. VR had no effect on FI. Obstetric factors such as foetal weight, instrumental delivery, episiotomy, perineal tear and total number of deliveries did not influence outcomes.
CONCLUSION
Patients with a less straightforward obstetric history can be reassured that this should not adversely influence the functional outcome after VR for ODS. Colorectal surgeons who offer this surgery should warn patients with an elevated BMI or with longstanding symptoms that the operation may be less successful than for those with a lower BMI or shorter duration of symptoms.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1111/codi.14392
- PMID 30171744
- Persistent URL
- https://sonar.ch/global/documents/232005
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