Resection rectopexy for internal rectal intussusception reduces constipation and incomplete evacuation of stool

Abstract

Objective: To study the effect of rectopexy and sigmoid resection (resection rectopexy) on symptoms in patients with internal rectal intussusception.

Design: Retrospective and prospective study.

Setting: University hospital, Norway.

Patients: 22 patients with internal rectal intussusception.

Interventions: Resection rectopexy by an open (n = 13) or laparoscopically-assisted (n = 9) technique.

Main outcome measures: Symptomatic outcome, patients' satisfaction, and morbidity. Outcome was based mainly on the validated KESS score, which covers 10 symptoms included in the definiton of constipation.

Results: There was a significant reduction in all 10 symptoms. Two patients complained of incontinence which improved after operation. The number of patients with constipation was reduced from 20 to 8 (p = 0.000) and none became constipated. Mean (95% CI) colonic transit times before and after operation in 10 patients with constipation were 5.3 (4.1 to 6.4) and 4.0 (2.6 to 5.4) days (p = 0.083). Seven of these 10 patients had a reduction of both transit time and constipation score. Six patients had complications after open operations. These included one damaged ureter, reoperations for bleeding, incomplete intestinal obstruction, and 2 wound infections.

Conclusion: Rectopexy with sigmoid resection resulted in improvement in symptoms, including constipation and feeling of incomplete rectal evacuation, and acceptable morbidity.