AI Article Synopsis
- A study comparing laparoscopic ventral mesh rectopexy (LVMR) and perineal stapler resection (PSR) in elderly patients with external full-thickness rectal prolapse showed that LVMR resulted in significantly fewer complications and lower recurrence rates.
- LVMR was linked to better postoperative outcomes, including less incontinence, less constipation, and higher patient satisfaction compared to PSR.
- Key predictors for prolapse recurrence included the surgical method used (LVMR associated with a 93% reduction in risk), the duration of symptoms, and the length of the prolapse.
Article Abstract
Background: In elderly patients with external full-thickness rectal prolapse (EFTRP), the exact differences in postoperative recurrence and functional outcomes between laparoscopic ventral mesh rectopexy (LVMR) and perineal stapler resection (PSR) have not yet been investigated.
Methods: We conducted a retrospective multicenter study on 330 elderly patients divided into LVMR group (n = 250) and PSR (n = 80) from April 2012 to April 2019. Patients were evaluated before and after surgery by Wexner incontinence scale, Altomare constipation scale, and patient satisfaction questionnaire. The primary outcomes were incidence and risk factors for EFTRP recurrence. Secondary outcomes were postoperative incontinence, constipation, and patient satisfaction.
Results: LVMR was associated with fewer postoperative complications (p < 0.001), lower prolapse recurrence (p < 0.001), lower Wexner incontinence score (p = 0.03), and lower Altomare's score (p = 0.047). Furthermore, LVMR demonstrated a significantly higher surgery-recurrence interval (p < 0.001), incontinence improvement (p = 0.019), and patient satisfaction (p < 0.001) than PSR. Three and 13 patients developed new symptoms in LVMR and PSR, respectively. The predictors for prolapse recurrence were LVMR (associated with 93% risk reduction of recurrence, OR 0.067, 95% CI 0.03-0.347, p = 0.001), symptom duration (prolonged duration was associated with an increased risk of recurrence, OR 1.131, 95% CI 1.036-1.236, p = 0.006), and length of prolapse (increased length was associated with a high recurrence risk (OR = 1.407, 95% CI = 1.197-1.655, p < 0.001).
Conclusions: LVMR is safe for EFTRP treatment in elderly patients with low recurrence, and improved postoperative functional outcomes.
Trial Registration: Clinical Trial.gov (NCT05915936), retrospectively registered on June 14, 2023.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11018677 | PMC |
| http://dx.doi.org/10.1007/s10151-024-02919-1 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Cardiovascular Safety and Fracture Prevention Effectiveness of Denosumab Versus Oral Bisphosphonates in Patients Receiving Dialysis : A Target Trial Emulation.
Ann Intern Med
January 2025
Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan (K.K.).
Background: Dialysis patients have high rates of fracture morbidity, but evidence on optimal management strategies for osteoporosis is scarce.
Objective: To determine the risk for cardiovascular events and fracture prevention effects with denosumab compared with oral bisphosphonates in dialysis-dependent patients.
Design: An observational study that attempts to emulate a target trial.
Association between pre-stroke frailty and post-discharge destination in acute stroke among Chinese older adults.
Top Stroke Rehabil
December 2024
Department of Nursing, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
Aims: To investigate the association between pre-stroke frailty and discharge destination in hospitalized older adults in China.
Methods: We conducted this prospective cohort study in a tertiary care hospital in China. We enrolled patients aged 60 years and older admitted to the hospital for acute stroke from January 2022 to May 2022.
Testing Machine Learning-Based Pain Assessment for Postoperative Geriatric Patients.
Comput Inform Nurs
January 2025
Author Affiliations: Zonguldak Atatürk State Hospital (Dr Alkan); and Faculty of Health Sciences, Department of Nursing, Zonguldak Bülent Ecevit University (Dr Taşdemir), Zonguldak, Turkey.
The global population is aging, and there is a concomitant increase in surgery for the elderly. In geriatric patients, where postoperative pain assessment is difficult, technological tools that perform automatic pain assessment are needed to alleviate the workload of nurses and to accurately assess patients' pain. This study offers a more reliable and rapid assessment tool for assessing the pain of elderly patients undergoing surgery.
View Article and Find Full Text PDFSomatization symptomology and its association with stress in patients with irritable bowel syndrome.
PLoS One
January 2025
Shifa College of Medicine, Shifa Tameer-e-Millat University, Islamabad, Pakistan.
Irritable Bowel Syndrome (IBS) patients and Somatization Symptom Disorder (SSD) patients experience somatization symptoms relative to their corresponding processes. IBS patients may also have a diagnosis of both IBS and SSD. Somatization symptoms cause significant psychological, emotional and social distress.
View Article and Find Full Text PDFInfluenza vaccine effectiveness against medically attended outpatient illness, United States, 2023-24 season.
Clin Infect Dis
January 2025
Influenza Division, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
Background: The 2023-24 U.S. influenza season was characterized by a predominance of A(H1N1)pdm09 virus circulation with co-circulation of A(H3N2) and B/Victoria viruses.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!