Long-term outcome of laparoscopic ventral rectopexy for full-thickness rectal prolapse: The PEXITY Study.

Background Laparoscopic ventral mesh rectopexy (LVR) has gained increasing acceptance for the treatment of patients with a full-thickness rectal prolapse (RP), but the literature on follow-up of at least ten years is scarce. We studied recurrence rate, long-term functional results, and quality of life in patients who had LVR for RP more than twelve years ago. Method The study population consisted of patients who could be contacted among the 175 who had undergone LVR for RP and whose short and medium-term outcomes were published in 2012. We studied the long-term recurrence rate (Kaplan-Meier), functional outcome (Wexner and ODS scores), quality of life (EuroQol), and satisfaction of the patient through clinical examination(s), specific scores, and questionnaires. Results Of the 175 patients, 14 patients had exclusion criteria, 57 had died, and 42 were lost to follow-up, leaving 62 patients for analysis. Seventeen patients presented with a recurrence (10.5%) at the 10-year follow up. The only statistically significant risk factor for recurrence was recurrent RP (HR = 11.5 (2.54–52.2), p = 0.002). The median faecal incontinence score was 4 (0–10) and significantly worse in patients who had a recurrence (12 (7–13) vs 3 (0–9); P = 0.016). The median obstructive defaecation score was 6 (3–12). The median quality of life score was 7 (6–8). Most patients who presented with a recurrence said they would undergo the operation again and recommended it, as would patients with no recurrence. Conclusion LVR for RP is a safe and efficient technique with sustainable long-term results that shows long-term efficacy at more than 10 years after the operation.