Minimally Invasive Mesh Rectopexy versus Perineal Rectosigmoidectomy in the Elderly: a Retrospective Comparative Analysis

Aim: The aim of this study was to compare early and intermediate perioperative outcomes after rectal prolapse repair in elderly patients undergoing either minimally invasive mesh rectopexy or perineal rectosigmoidectomy (PR). Method: This retrospective comparative analysis evaluated the outcomes of...

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Main Authors: Jordan Martucci, Aubrey Swinford, Brian Williams, Abhinav Gupta, Kyle Graham Cologne, Sarah Elizabeth Koller, Marjun Philip Duldulao, Joongho Shin, Sang Won Lee
Format: Article
Language:English
Published: Galenos Publishing House 2025-03-01
Series:Turkish Journal of Colorectal Disease
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Online Access:https://www.turkishjcrd.com/articles/minimally-invasive-mesh-rectopexy-versus-perineal-rectosigmoidectomy-in-the-elderly-a-retrospective-comparative-analysis/doi/tjcd.galenos.2025.2025-1-3
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author Jordan Martucci
Aubrey Swinford
Brian Williams
Abhinav Gupta
Kyle Graham Cologne
Sarah Elizabeth Koller
Marjun Philip Duldulao
Joongho Shin
Sang Won Lee
author_facet Jordan Martucci
Aubrey Swinford
Brian Williams
Abhinav Gupta
Kyle Graham Cologne
Sarah Elizabeth Koller
Marjun Philip Duldulao
Joongho Shin
Sang Won Lee
author_sort Jordan Martucci
collection DOAJ
description Aim: The aim of this study was to compare early and intermediate perioperative outcomes after rectal prolapse repair in elderly patients undergoing either minimally invasive mesh rectopexy or perineal rectosigmoidectomy (PR). Method: This retrospective comparative analysis evaluated the outcomes of elderly patients (age ≥70 years) who underwent surgical correction of full-thickness rectal prolapse at a single tertiary hospital between 2010 and 2023. Patients included in the study had undergone either minimally invasive rectopexy (MIR) or PR (Altemeier procedure). The primary outcomes assessed were 30-day mortality and complication rates. Results: A total of 55 patients were included, with 42 who underwent MIR and 13 who underwent PR. The average age of all the patients was 79.8±6.4 years, and the average body mass index was 22.5±3.7. Most patients (49, 89.1%) were women. Patients who underwent MIR had a significantly lower 30-day complication rate than those who underwent PR (11.9% vs. 53.8%, respectively; p=0.001). No deaths occurred in either group within 30 days of the procedure. Patients who underwent PR had similar recurrence rates to those who underwent MIR, with a median interval to the first documented recurrence of 6.0 months (range: 0.2-24.5 months). The rate of normal bowel function achieved at the most recent follow-up was significantly higher in patients who underwent MIR than in those who underwent PR (76.2% vs. 30.8%, respectively; p=0.003). Conclusion: The MIR approach to prolapse repair is safe and feasible in elderly patients, with a lower 30-day complication rate and comparable mortality rates than PR. Additionally, early functional outcomes are better after MIR.
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language English
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series Turkish Journal of Colorectal Disease
spelling doaj-art-16c345e3091b4044b20e201f2a3a32d02025-08-20T03:40:06ZengGalenos Publishing HouseTurkish Journal of Colorectal Disease2536-48982536-49012025-03-01351233010.4274/tjcd.galenos.2025.2025-1-3Minimally Invasive Mesh Rectopexy versus Perineal Rectosigmoidectomy in the Elderly: a Retrospective Comparative AnalysisJordan Martucci0https://orcid.org/0009-0007-3971-750XAubrey Swinford1https://orcid.org/0000-0001-9668-4774Brian Williams2https://orcid.org/0000-0003-3222-3818Abhinav Gupta3https://orcid.org/0000-0003-3823-7890Kyle Graham Cologne4https://orcid.org/0000-0002-4449-4220Sarah Elizabeth Koller5https://orcid.org/0000-0002-9845-1429Marjun Philip Duldulao6https://orcid.org/0000-0002-9549-2057Joongho Shin7https://orcid.org/0000-0001-6130-2422Sang Won Lee8https://orcid.org/0000-0001-8817-2349Keck Hospital of University of Southern California, Department of Colorectal Surgery, California, United States of AmericaKeck Hospital of University of Southern California, Department of Colorectal Surgery, California, United States of AmericaKeck Hospital of University of Southern California, Department of Colorectal Surgery, California, United States of AmericaKeck Hospital of University of Southern California, Department of Colorectal Surgery, California, United States of AmericaKeck Hospital of University of Southern California, Department of Colorectal Surgery, California, United States of AmericaLos Angeles General Medical Center, Department of Colorectal Surgery, California, United States of AmericaKeck Hospital of University of Southern California, Department of Colorectal Surgery, California, United States of AmericaKeck Hospital of University of Southern California, Department of Colorectal Surgery, California, United States of AmericaKeck Hospital of University of Southern California, Department of Colorectal Surgery, California, United States of AmericaAim: The aim of this study was to compare early and intermediate perioperative outcomes after rectal prolapse repair in elderly patients undergoing either minimally invasive mesh rectopexy or perineal rectosigmoidectomy (PR). Method: This retrospective comparative analysis evaluated the outcomes of elderly patients (age ≥70 years) who underwent surgical correction of full-thickness rectal prolapse at a single tertiary hospital between 2010 and 2023. Patients included in the study had undergone either minimally invasive rectopexy (MIR) or PR (Altemeier procedure). The primary outcomes assessed were 30-day mortality and complication rates. Results: A total of 55 patients were included, with 42 who underwent MIR and 13 who underwent PR. The average age of all the patients was 79.8±6.4 years, and the average body mass index was 22.5±3.7. Most patients (49, 89.1%) were women. Patients who underwent MIR had a significantly lower 30-day complication rate than those who underwent PR (11.9% vs. 53.8%, respectively; p=0.001). No deaths occurred in either group within 30 days of the procedure. Patients who underwent PR had similar recurrence rates to those who underwent MIR, with a median interval to the first documented recurrence of 6.0 months (range: 0.2-24.5 months). The rate of normal bowel function achieved at the most recent follow-up was significantly higher in patients who underwent MIR than in those who underwent PR (76.2% vs. 30.8%, respectively; p=0.003). Conclusion: The MIR approach to prolapse repair is safe and feasible in elderly patients, with a lower 30-day complication rate and comparable mortality rates than PR. Additionally, early functional outcomes are better after MIR.https://www.turkishjcrd.com/articles/minimally-invasive-mesh-rectopexy-versus-perineal-rectosigmoidectomy-in-the-elderly-a-retrospective-comparative-analysis/doi/tjcd.galenos.2025.2025-1-3rectal prolapserectopexyperineal rectosigmoidectomyminimally invasive surgical techniquesperioperative care
spellingShingle Jordan Martucci
Aubrey Swinford
Brian Williams
Abhinav Gupta
Kyle Graham Cologne
Sarah Elizabeth Koller
Marjun Philip Duldulao
Joongho Shin
Sang Won Lee
Minimally Invasive Mesh Rectopexy versus Perineal Rectosigmoidectomy in the Elderly: a Retrospective Comparative Analysis
Turkish Journal of Colorectal Disease
rectal prolapse
rectopexy
perineal rectosigmoidectomy
minimally invasive surgical techniques
perioperative care
title Minimally Invasive Mesh Rectopexy versus Perineal Rectosigmoidectomy in the Elderly: a Retrospective Comparative Analysis
title_full Minimally Invasive Mesh Rectopexy versus Perineal Rectosigmoidectomy in the Elderly: a Retrospective Comparative Analysis
title_fullStr Minimally Invasive Mesh Rectopexy versus Perineal Rectosigmoidectomy in the Elderly: a Retrospective Comparative Analysis
title_full_unstemmed Minimally Invasive Mesh Rectopexy versus Perineal Rectosigmoidectomy in the Elderly: a Retrospective Comparative Analysis
title_short Minimally Invasive Mesh Rectopexy versus Perineal Rectosigmoidectomy in the Elderly: a Retrospective Comparative Analysis
title_sort minimally invasive mesh rectopexy versus perineal rectosigmoidectomy in the elderly a retrospective comparative analysis
topic rectal prolapse
rectopexy
perineal rectosigmoidectomy
minimally invasive surgical techniques
perioperative care
url https://www.turkishjcrd.com/articles/minimally-invasive-mesh-rectopexy-versus-perineal-rectosigmoidectomy-in-the-elderly-a-retrospective-comparative-analysis/doi/tjcd.galenos.2025.2025-1-3
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