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| Selective strategy of laparoscopic rectopexy in the treatment of rectal prolapse |
| CHEN Qin LI Yufei ZHOU Jiaojiao LI Huashan |
| Department of Proctology, Guang′anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China |
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Abstract Laparoscopic rectopexy is one of the main methods to treat rectal prolapse. According to the degree of rectal dissociation, fixation method, the absence of rectum and sigmoidectomy, the surgical methods are divided into laparoscopic ventral rectopexy, laparoscopic ventral mesh rectopexy, laparoscopic suture rectopexy, laparoscopic resection rectopexy, laparoscopic anterior rectopexy and laparoscopic posterior rectopexy. The laparoscopic ventral rectopexy is the most widely used in clinical practice and has become the first choice for the treatment of rectal prolapse. The application of laparoscopic ventral mesh rectopexy is still controversial and needs further study. Laparoscopic suture rectopexy can be used in children with rectal prolapse, and has a good effect. Laparoscopic resection rectopexy can improve fecal incontinence but may increase the risk of constipation. Laparoscopic anterior rectopexy is safe and effective in the treatment of elderly patients and patients with body debility. The problem of postoperative constipation still remains to be solved after laparoscopic posterior rectopexy. Therefore, according to the different degrees of patients′ age, physical conditions, anatomical abnormalities, functional disorders and other differences, good indications and appropriate fixation methods for individualized treatment will greatly improve the efficacy of surgery, reduce complications and the recurrence rate, improve the intestinal function and the satisfaction of patients.
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