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Long-term outcomes of robotic ventral mesh rectopexy for external rectal prolapse

机译：用于外直肠脱垂的机器人腹端直肠长期成果

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Introduction Nowadays in Europe, laparoscopic ventral mesh rectopexy is the gold standard treatment of external rectal prolapse (ERP). The benefits of robot ventral mesh rectopexy (RVMR) are not clearly defined. The primary objective of the study was to evaluate the long-term results of RVMR. The secondary objective was to determine predictive factors of recurrence. Design Monocentric, retrospective study. Data, both pre-operative and peri-operative, were collected, and follow-up data were assessed prospectively by a telephone questionnaire. The study was performed in a tertiary referral center. Methods Between August 2007 and August 2017, we evaluate all consecutive patients who underwent RVMR for ERP by three different surgeons. The primary outcome was the recurrence rate perceived by patients. Secondary outcome were functional results based on Knowles-Eccersley-Scott-Symptom score for constipation and Wexner score for incontinence, compared before and after surgery. Results During the study period 96 patients (86 women) underwent RVMR. The mean age was 62.3 years (range 16-90). Twelve patients had a history of ERP repair. Sixty-nine patients were analyzed for long-term outcomes with a mean follow-up of 37 months (range 2.3-92 months). Recurrence rate was 12.5%. After surgery, constipation was significantly reduced: 44 patients were constipated before surgery versus 23 after surgery. Six patients described de novo constipation (6.25%). Fecal incontinence was significantly reduced: 59 patients were incontinent before surgery versus 14 after surgery. No predictive factor for recurrence was identified after multivariate analysis. No mesh related complications were related. Conclusions In conclusion, RVMR presents good long-term functional result and a recurrence rate similar to LVMR as published in the literature. The rate of mesh related complications seems lower.
机译：如今，欧洲目前，腹腔镜腹网状螺母是外直肠脱垂（ERP）的金标准治疗。没有明确定义机器人腹网状螺钉（RVMR）的好处。该研究的主要目标是评估RVMR的长期结果。二级目标是确定复发的预测因素。设计单眼，回顾性研究。收集预审和PERI操作的数据，并通过电话问卷评估和后续数据。该研究在第三节推荐中心进行。方法2007年8月至2017年8月，我们评估了三种不同外科医生接受了RVMR的所有连续患者。主要结果是患者感知的复发率。次要结果是基于Knowles-Eccerley-Scott-症状评分的功能结果，用于在手术前后进行的便秘和Wexner评分进行尿失禁。结果在研究期间96名患者（86名妇女）接受了RVMR。平均年龄为62.3岁（范围16-90）。 12名患者有ERP修复的历史。分析六十九个患者的长期结果，平均随访37个月（2.3-92个月）。复发率为12.5％。手术后，便秘明显减少：手术前患者在手术前服用44名患者。六名患者描述了Novo便秘（6.25％）。粪便尿失禁明显减少：手术前的手术前59名患者失禁。在多变量分析后鉴定了复发的预测因素。没有网格相关的并发症是相关的。结论总之，RVMR呈现出良好的长期功能效果和与文献中发布的LVMR类似的复发率。网格相关并发症的速度似乎较低。

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