Clinical Outcome After Resection Rectopexy in Patients with Constipation and Rectal Prolapse

Laparoscopic resection rectopexy (LRR) is an established procedure for the treatment of rectal prolapse. This study evaluated constipation and gastrointestinal quality of life in patients before and after LRR for rectal prolapse. Methods: 30 patients (24 females, 6 males) underwent laparoscopic anterior (n=14), posterior (n=8), or suture resection rectopexy (n=8) for rectal prolapse between 2010–2020. Among them, 25 were retrospectively evaluated for constipation and gastrointestinal quality of life using the Cleveland Clinic Constipation Score (CCCS) and Gastrointestinal Quality of Life Index (GIQLI). Results: The median constipation score fell significantly from 16.0±6.4 to 6.0±4.7 after 68.0±42.8 months (P<0.001). Constipation improved in 20 (80.0%), remained unaltered in 2, and worsened in 3 patients. Prior abdominal surgeries were associated with less constipation improvement (P<0.05). A significant improvement in GIQLI score was observed, with the median total GIQLI score increasing from 95.0±14.8 to 124.0±18.2 (P<0.001). The quality of life improved in 21 patients (84.0%). Positive changes were observed in the GIQLI subscales of gastrointestinal symptoms, emotions, physical status, social dysfunction, and effects of medical treatment (P<0.001). There was no difference in outcome between the three procedures. Conclusion: Laparoscopic resection rectopexy for rectal prolapse is safe, feasible, and highly effective regarding both perioperative results and long-term functional outcomes. Our results suggest that LRR significantly improves constipation in patients with outlet obstruction and contributes to a higher quality of life.