Laparoscopic resection rectopexy versus laparoscopic mesh rectopexy for rectoanal intussusception

Background and aim: Rectoanal intussusception (RI) can be treated by laparoscopic rectopexy successfully following different techniques. This study aims to compare laparoscopic resection rectopexy with laparoscopic ventral mesh rectopexy in patients with RI. Patients and methods: From February 2012 to February 2014, 28 patients with RI were admitted to the Colorectal Surgery Unit, Mansoura University. The patients were divided into two groups: the ventral mesh rectopexy group and the resection rectopexy group. Postoperative improvement in clinical symptoms, symptoms scores, anorectal manometry, and defecography were evaluated over 12 months. Results: Eleven (39.3%) patients were male and 17 (60.7%) were female, with a mean age of 43.42 years. Improvement in obstructed defecation symptoms was observed in 22 (78.5%) patients overall: 85.7% in the resection rectopexy group and 71.4% in the ventral mesh rectopexy group (P = 0.648). The mean Wexner score dropped from 15.57 to 4.8 at 3 months (P = 0.0025). The mean operative time was 2.97 h in the resection rectopexy group versus 2.14 h in the ventral mesh rectopexy group (P = 0.0003). Minor morbidities were detected in five cases and no mortality was reported. Recurrence was diagnosed in six (21.4%) patients at 1 year. Conclusion: Laparoscopic resection rectopexy is superior to ventral mesh rectopexy despite longer operative time, longer hospital stay, and higher risk of complications