Orr-loygue rectopexy with limited dissection for symptomatic rectalprolapse: LTP05


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Abstract

Aim:The aim of this work was to evaluate the outcome of a modified Orr-Loygue technique adopted in our unit to manage complete rectalprolapse (CRP) and recto-anal intussusception (RAI) associated with genitalprolapse and or enterocele.Method:A retrospective database was used to audit our 10 years experience of this technique. The rectum was mobilized posteriorly to the level of the lateral ligaments avoiding nerve damage. Lateral ligament division was never applied. Anteriorly the Douglas pouch was opened. A polypropylene mesh, trousers shaped, was fixed to the sacralpromontory and sutured to the anterolateral rectal walls and vaginal vault.Results:Ninety-two patients underwent modified Orr-Loygue: 18 patients suffered a CRP and 74 had RAI. The mean operating time was 158 min. Laparoscopic approach was used whenever possible (82.6% of cases). The mean hospital stay was 7 days. Complications occurred in 14% of patients. Mean follow-up was 42.6 months. Preoperative constipation was resolved or improved in 67% of patients. Preoperative fecal incontinence improved in 8/10 patients. Recurrence rate was 3.4%. Two cases of new onset postoperative obstructed defecation occurred.Conclusion:Modified Orr-Loygueprocedure is safe, with relatively low morbidity. In the long term, itprovides good results in treating rectalprolapse.

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