Abdominal versus perineal approach for external rectal prolapse: systematic review with meta-analysis
- Resource Type
- Authors
- Gianluca Pellino; Giacomo Fuschillo; Costantinos Simillis; Lucio Selvaggi; Giuseppe Signoriello; Danilo Vinci; Christos Kontovounisios; Francesco Selvaggi; Guido Sciaudone
- Source
- Scientia
- Subject
- Constipation
Humans
Length of Stay
Randomized Controlled Trials as Topic
Retrospective Studies
Rectal Prolapse
REPAIR
Science & Technology
STATEMENT
enfermedades del sistema digestivo::enfermedades gastrointestinales::enfermedades intestinales::enfermedades del recto::prolapso rectal [ENFERMEDADES]
Otros calificadores::Otros calificadores::/cirugía [Otros calificadores]
General Medicine
Other subheadings::Other subheadings::/surgery [Other subheadings]
Digestive System Diseases::Gastrointestinal Diseases::Intestinal Diseases::Rectal Diseases::Rectal Prolapse [DISEASES]
Retrospective Studie
MANAGEMENT
Surgery
Recte - Malalties - Cirurgia
CONSENSUS
Life Sciences & Biomedicine
Human
- Language
- English
Background External rectal prolapse (ERP) is a debilitating condition in which surgery plays an important role. The aim of this study was to evaluate the outcomes of abdominal approaches (AA) and perineal approaches (PA) to ERP. Methods This was a PRISMA-compliant systematic review with meta-analysis. Studies published between 1990 and 2021 were retrieved. The primary endpoint was recurrence at the last available follow-up. Secondary endpoints included factors associated with recurrence and function. All studies were assessed for bias using the Newcastle–Ottawa Scale and Cochrane tool. Results Fifteen studies involving 1611 patients (AA = 817; PA = 794) treated for ERP were included, three of which were randomized controlled trials (RCTs; 114 patients (AA = 54; PA = 60)). Duration of follow-up ranged from 12 to 82 months. Recurrence in non-randomized studies was 7.7 per cent in AA versus 20.1 per cent in PA (odds ratio (OR) 0.29, 95 per cent confidence interval (c.i.) 0.17 to 0.50; P Conclusion The overall risk of recurrence of ERP appears to be higher with PA versus AA. Incontinence is less frequent after AA but at the cost of increased constipation. Age at surgery and duration of follow-up are associated with increased risk of recurrence, which warrants adequate reporting of future studies on this topic.