The effect of total colectomy with posterior suture rectopexy in patients with internal prolapse and colonic inertia; A case series on 9 women.

Abstract

<h4>Introduction and importance</h4>The benefits of ventral mesh rectopexy, performed by laparoscopic method, simultaneous with total laparoscopic colectomy, for patients with internal rectal prolapse (IRP), have been shown previously. Considering the advantages of posterior suture rectopexy in patients with colonic inertia, we hypothesized that patients with IRP and colonic inertia may benefit from combination of posterior suture rectopexy with total laparoscopic colectomy, while this has not been evaluated, to date.<h4>Case presentation</h4>In the present study, we performed laparoscopic posterior rectopexy with total colectomy on 9 women with refractory constipation, who were indicated for surgical correction of chronic constipation, due to obstructed defecation syndrome and IRP grade 2 and 3; IRP was diagnosed based on the results of defecography and colonic inertia based on impaired colon transit time.<h4>Clinical discussion</h4>The results showed significant reduction in Wexner constipation score, form of stool, and patient assessment of constipation quality of life (PAC-QOL).<h4>Conclusion</h4>This case series suggest the feasibility and advantages of performing total laparoscopic colectomy and laparoscopic posterior suture rectopexy in patients with IRP and colonic inertia, indicated for surgical correction of constipation. In future, cohort and clinical trials can identify the superiority of this combinational method over each method alone.