Safety of Laparoscopic Ventral Rectopexy in the Elderly. Issue 3 (March 2015)

• Record Type: Journal Article
• Authors: Gultekin, Fatma A.; Wong, Mark T. C.; Podevin, Juliette; Barussaud, Marie-Line; Boutami, Myriam; Lehur, Paul A.; Meurette, Guillaume
• Is Part Of: Diseases of the colon & rectum. Volume 58:Issue 3(2015:Mar.)
• Publication Date: 2015-03
• Subjects: Colon (Anatomy) -- Diseases -- Periodicals; Rectum -- Diseases -- Periodicals; Colonic Diseases -- Periodicals; Colorectal Surgery -- Periodicals; 616.34
• DOI: 10.1097/DCR.0000000000000308
• Languages: English
• ISSNs: 0012-3706

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>BACKGROUND:</title> <p>Laparoscopic ventral rectopexy is an established procedure in the treatment of posterior pelvic organ prolapse. It is still unclear whether this procedure can be performed safely in the elderly.</p> </sec> <sec> <title>OBJECTIVE:</title> <p>This study aimed to assess the effects of age on the outcome of laparoscopic ventral rectopexy performed for patients with pelvic organ prolapse.</p> </sec> <sec> <title>DESIGN:</title> <p>This study was a retrospective cohort analysis with data from a national registry.</p> </sec> <sec> <title>SETTINGS:</title> <p>The study was conducted in a tertiary care setting.</p> </sec> <sec> <title>PATIENTS:</title> <p>Patients undergoing laparoscopic ventral rectopexy were identified from discharge summaries. Patients were stratified according to age, including patients <70 (group A) and ≥70 (group B) years old.</p> </sec> <sec> <title>MAIN OUTCOME MEASURES:</title> <p>Variables analyzed included sex, age, diagnosis, associated pelvic organ prolapse, comorbidities, length of stay, complications (Clavien-Dindo scale), and mortality.</p> </sec> <sec> <title>RESULTS:</title> <p>Among 4303 patients (98.2% women) who underwent a laparoscopic ventral rectopexy, 1263 (29.4%) were >70 years old (mean age, 76.2 ± 5.0 years). Main diagnoses were vaginal vault prolapse (53.0% [group A] vs 47.0% [group B]; <italic>p</italic> value not significant) and rectal prolapse (17.7 vs 26.8%; <italic>p</italic> value not significant). Comorbidity was significantly increased in group B (mean length of stay, 5.6 ± 3.6 vs 4.7 ± 1.8 days; <italic>p</italic> < 0.001) and minor complications (8.4% vs 5.0%; <italic>p</italic> < 0.001) were significantly increased in group B, whereas major complications were not different (group A, 0.7%; group B, 0.9%; <italic>p</italic> = 0.40) after univariate analysis. Multivariate analysis found no significant differences between groups. The subgroup analysis of patients >80 years old (n = 299) showed no differences. Each group had 1 postoperative mortality.</p> </sec> <sec> <title>LIMITATIONS:</title> <p>Limitations of the study include its retrospective design, lack of prestudy power calculation, possible inaccuracy of an administrative database, and selection bias.</p> </sec> <sec> <title>CONCLUSIONS:</title> <p>Laparoscopic ventral rectopexy appears to be safe in select elderly patients.</p> </sec> </abstract>