Systematic literature review and meta-analysis of surgical treatment of complete rectal prolapse in male patients.

IF 2.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Techniques in Coloproctology Pub Date : 2024-11-13 DOI:10.1007/s10151-024-03039-6

S H Emile, A Wignakumar, N Horesh, Z Garoufalia, V Strassmann, M Boutros, S D Wexner

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Abstract

Background: Rectal prolapse often affects women but may also affect men. This systematic review aimed to provide outcomes of surgery for complete rectal prolapse reported in studies with a predominantly male population.

Methods: This PRISMA-compliant systematic literature review searched PubMed and Scopus between January 2000 and February 2024; Google Scholar was queried for studies reporting outcomes of complete rectal prolapse surgery in predominately (> 90%) male populations. Main outcome measures were recurrence, complications, operative time, and bowel function.

Results: Eight studies (452 patients; median age 45.6 years) were included; 80.5% of patients underwent abdominal procedures whereas 19.5% underwent perineal procedures. The prevalence of recurrence was 11.2% after ventral mesh rectopexy (VMR), 0.8% after posterior mesh rectopexy (PMR), 0 after resection rectopexy, and 19.3% after perineal procedures. The prevalence of complications was 13.9% after VMR, 13.1% after PMR, 43.3% after resection rectopexy, and 17.4% after perineal procedures. The most improvement in constipation was noted after resection rectopexy (83.3-100%) and in fecal incontinence (FI) was noted after posterior mesh rectopexy (86.4-90%). Abdominal procedures had lower rates of recurrence (6% vs. 19.3%, RR 0.50, 95% CI 0.21-1.18, p = 0.113), similar complication rates (14.3% vs. 13.6%, RR 0.41, 95% CI 0.06-2.9, p = 0.374), and longer operative times (116 ± 47.2 vs. 74.2 ± 23.6 min, p < 0.001).

Conclusions: Treatment of rectal prolapse in male patients undergoing abdominal procedures was associated with longer operative times, lower recurrence rates, and similar complications to perineal procedures. PMR and resection rectopexy had the lowest recurrence. The most improvement in FI and constipation was noted after PMR and resection rectopexy, respectively.

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男性完全性直肠脱垂手术治疗的系统性文献综述和荟萃分析。

背景：直肠脱垂通常影响女性，但也可能影响男性。本系统性综述旨在提供以男性为主的研究报告中关于完全性直肠脱垂手术的结果：这项符合 PRISMA 标准的系统性文献综述检索了 2000 年 1 月至 2024 年 2 月间的 PubMed 和 Scopus；还查询了 Google Scholar，以了解报告男性为主（> 90%）的完全性直肠脱垂手术结果的研究。主要结果指标为复发、并发症、手术时间和肠道功能：结果：共纳入了 8 项研究（452 名患者；中位年龄 45.6 岁）；80.5% 的患者接受了腹部手术，19.5% 的患者接受了会阴手术。腹腔网片直肠切除术（VMR）后复发率为11.2%，后方网片直肠切除术（PMR）后复发率为0.8%，切除直肠切除术后复发率为0，会阴手术后复发率为19.3%。VMR术后并发症发生率为13.9%，PMR术后为13.1%，切除直肠整形术后为43.3%，会阴手术后为17.4%。切除直肠术后便秘的改善率最高（83.3%-100%），后网膜直肠术后大便失禁的改善率最高（86.4%-90%）。腹部手术的复发率较低（6% vs. 19.3%，RR 0.50，95% CI 0.21-1.18，p = 0.113），并发症发生率相似（14.3% vs. 13.6%，RR 0.41，95% CI 0.06-2.9，p = 0.374），手术时间较长（116 ± 47.2 vs. 74.2 ± 23.6 分钟，p 结论：腹部手术的复发率较低，并发症发生率相似（14.3% vs. 13.6%，RR 0.41，95% CI 0.06-2.9，p = 0.374）：男性患者接受腹部手术治疗直肠脱垂时，手术时间较长，复发率较低，并发症与会阴手术相似。PMR和直肠切除术的复发率最低。PMR和切除直肠整形术对FI和便秘的改善最大。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Techniques in Coloproctology GASTROENTEROLOGY & HEPATOLOGY-SURGERY

CiteScore

5.30

自引率

9.10%

发文量

176

审稿时长

1 months

期刊介绍： Techniques in Coloproctology is an international journal fully devoted to diagnostic and operative procedures carried out in the management of colorectal diseases. Imaging, clinical physiology, laparoscopy, open abdominal surgery and proctoperineology are the main topics covered by the journal. Reviews, original articles, technical notes and short communications with many detailed illustrations render this publication indispensable for coloproctologists and related specialists. Both surgeons and gastroenterologists are represented on the distinguished Editorial Board, together with pathologists, radiologists and basic scientists from all over the world. The journal is strongly recommended to those who wish to be updated on recent developments in the field, and improve the standards of their work. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1965 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the Principles of Laboratory Animal Care (NIH publication no. 86-23 revised 1985) were followed as were applicable national laws (e.g. the current version of the German Law on the Protection of Animals). The Editor-in-Chief reserves the right to reject manuscripts that do not comply with the above-mentioned requirements. Authors will be held responsible for false statements or for failure to fulfill such requirements.