The feasibility, safety and short-term clinical efficacy of laparoscopic resection rectopexy with natural orifice specimen extraction surgery for the treatment of complete rectal prolapse.

PURPOSE: There have been few reports that have focused on the combination of the laparoscopic approach and natural orifice specimen extraction (NOSE) surgery for complete rectal prolapse (CRP). The aim of this study was to compare the feasibility, safety and short-term clinical efficacy of NOSE surgery with those of conventional laparoscopic resection rectopexy in the treatment of CRP.

METHODS

In a group of 45 patients selected between January 2019 and October 2023, 28 patients underwent conventional laparoscopic resection rectopexy (LRR), and 17 patients underwent transanal NOSE laparoscopic resection rectopexy (NOSE–LRR). Preoperative and postoperative clinical variables of the two groups of patients were compared and analyzed.

RESULTS

The mean operation time was longer in the NOSE–LRR group than in the LRR group (150.29 min versus 134.18 min, respectively, p < 0.001). The median length of hospital stay after surgery was significantly shorter in the NOSE–LRR group (5 versus 7 days, respectively, p < 0.001). A significant reduction in the incontinence score and constipation score was observed in both groups after surgery (p < 0.001). However, there was no significant difference in the postoperative constipation score or incontinence score between the two groups.

CONCLUSION

In this study, LRR combined with NOSE appears to be a safe, technically feasible, cosmetically favorable, and effective surgical option for patients with CRP. NOSE–LRR was associated with a significantly shorter postoperative hospital stay but a longer operation time. However, further large-scale cohort studies are needed to validate these findings.