Clinical effect of laparoscopic suspension fixation combined with Sigmoid colon folding in treatment of complete rectal prolapse

Abstract:

Objective To investigate the clinical effect of suspension fixation combined with Sigmoid colon folding in the treatment of complete rectal prolapse.Methods A total of 50 patients with complete rectal prolapse who were admitted to The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from February 2017 to May 2023 were enrolled，and according to the surgical procedure，they were divided into control group with 20 patients and observation group with 30 patients. The patients in the control group underwent Delorme surgery，and those in the observation group underwent suspension fixation combined with Sigmoid colon folding for rectal prolapse. The two groups were compared in terms of clinical outcome，clinical recovery on day 30 after surgery，complications，recurrence rate at 1 year after surgery，and anorectal pressure before and after treatment，and functional efficacy was evaluated based on Wexner fecal incontinence score.Results The observation group had a higher overall cure rate than the control group（P=0.012）. On day 30 after surgery，compared with the control group，the observation group had significantly lower scores of anal pendant expansion（t=2.300，P=0.026），stool control ability（t=2.299，P=0.026），and anal moisture（t=2.205，P=0.032）. At 1 month after surgery，the observation group had a significantly lower overall incidence rate of complications than the control group（χ²=6.255，P=0.012）. On day 90 after surgery，both groups had a significant reduction in rectal sensory volume（t=20.634，P<0.001） and significant increases in maximum resting pressure（MRP） and maximum squeeze pressure（MSP），and the observation group had significantly higher MRP（t=-11.486，P<0.001） and MSP（t=-7.358，P<0.001） than the control group. After 1 year of follow-up，the observation group had a lower recurrence rate than the control group（P=0.033）. At 3 months after surgery，there was no significant difference between the two groups in the total score of passing of flatus，liquid stool，solid stool，pad wearing，and lifestyle change（t=0.197，P=0.845）.Conclusion Suspension fixation combined with Sigmoid colon folding has a better clinical effect than Delorme surgery in the treatment of complete rectal prolapse，with less intraoperative trauma，fewer complications，faster recovery，and a lower long-term recurrence rate.