EXPRESSION OF CONCERN
EXPRESSION OF CONCERN: Laparoscopic ventral rectopexy for external rectal prolapse is safe and effective in the elderly. Does this make perineal procedures obsolete?
An Expression of Concern has been raised for this article:
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EXPRESSION OF CONCERN: Laparoscopic Ventral Rectopexy for External Rectal Prolapse is Safe and Effective in the Elderly. Does This Make Perineal Procedures Obsolete?
- Volume 27Issue 3Colorectal Disease
- First Published online: March 25, 2025
N. Wijffels,
C. Cunningham,
A. Dixon, G. Greenslade, I. Lindsey,
N. Wijffels
Pelvic Floor Centre, Churchill Hospital, Oxford, UK
Search for more papers by this authorC. Cunningham
Pelvic Floor Centre, Churchill Hospital, Oxford, UK
Search for more papers by this authorN. Wijffels,
C. Cunningham,
A. Dixon, G. Greenslade, I. Lindsey,
N. Wijffels
Pelvic Floor Centre, Churchill Hospital, Oxford, UK
Search for more papers by this authorC. Cunningham
Pelvic Floor Centre, Churchill Hospital, Oxford, UK
Search for more papers by this authorMr Ian Lindsey, Oxford Pelvic Floor Centre, Churchill Hospital, Oxford, UK.E-mail: [email protected]
Abstract
Aim Perineal approaches are considered to be the ‘gold standard’ in treating elderly patients with external rectal prolapse (ERP) because morbidity and mortality with perineal approaches are lower compared with transabdominal approaches. Higher recurrence rates and poorer function are tolerated as a compromise. The aim of the present study was to assess the safety of laparoscopic ventral rectopexy (LVR) in elderly patients, compared with perineal approaches.
Method The prospectively collected databases from two tertiary referral pelvic floor units were interrogated to identify outcome in patients of 80 years of age and older with full-thickness ERP treated by LVR. The primary end-points were age, American Society of Anesthesiology (ASA) grade, mortality, and major and minor morbidity. Secondary end-points were length of stay (LOS) and recurrence.
Results Between January 2002 and December 2008, 80 [median age 84 (80–97) years] patients underwent rectopexy. The mean ± standard deviation ASA grade was 2.44 (±0.57) (two patients were ASA grade I, 42 patients were ASA grade II, 35 patients were ASA grade III and one patient was ASA grade IV). The median LOS was 3 (range 1–37) days. There was no mortality, and 10 (13%) patients had complications (one major and nine minor). At a median follow-up of 23 (2–82) months, two (3%) patients had developed a recurrent full-thickness prolapse.
Conclusion LVR is a safe procedure for using to treat full-thickness ERP in elderly patients. Mortality, morbidity and hospital stay are comparable with published rates for perineal procedures, with a 10-fold lower recurrence.
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