Resection rectopexy for internal rectal intussusception reduces constipation and incomplete evacuation of stool.

OBJECTIVE

To study the effect of rectopexy and sigmoid resection (resection rectopexy) on symptoms in patients with internal rectal intussusception.

DESIGN

Retrospective and prospective study.

SETTING

University hospital, Norway.

PATIENTS: 22 patients with internal rectal intussusception.

INTERVENTIONS: Resection rectopexy by an open (n = 13) or laparoscopically-assisted (n = 9) technique.

MAIN OUTCOME MEASURES: Symptomatic outcome, patients' satisfaction, and morbidity. Outcome was based mainly on the validated KESS score, which covers 10 symptoms included in the definiton of constipation.

RESULTS

There was a significant reduction in all 10 symptoms. Two patients complained of incontinence which improved after operation. The number of patients with constipation was reduced from 20 to 8 (p = 0.000) and none became constipated. Mean (95% CI) colonic transit times before and after operation in 10 patients with constipation were 5.3 (4.1 to 6.4) and 4.0 (2.6 to 5.4) days (p = 0.083). Seven of these 10 patients had a reduction of both transit time and constipation score. Six patients had complications after open operations. These included one damaged ureter, reoperations for bleeding, incomplete intestinal obstruction, and 2 wound infections.

CONCLUSION

Rectopexy with sigmoid resection resulted in improvement in symptoms, including constipation and feeling of incomplete rectal evacuation, and acceptable morbidity.