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Observational Study
. 2025 Apr;27(4):e70084.
doi: 10.1111/codi.70084.

Ventral mesh rectopexy: Variations in technique and care process. A multicentre study

Ellen Coeckelberghs  1 , Ahmed M Chaoui  2 , Mohamed Abasbassi  3 , Gabriele Bislenghi  2 , Katrien Boon  4 , Michel Goethals  5 , Tom Hendrickx  6 , Bert Houben  7 , Marc Krick  8 , Frederic Meekers  9 , Paul Pattyn  10 , Pieter Pletinckx  11 , Deborah Seys  1 , Jasper Stijns  12 , Sylvie Van den Broeck  13   14 , Bart Van Geluwe  15 , Yves Pirenne  16 , Albert M Wolthuis  2 , Kris Vanhaecht  1 , André D'Hoore  2
Affiliations
Observational Study

Ventral mesh rectopexy: Variations in technique and care process. A multicentre study

Ellen Coeckelberghs et al. Colorectal Dis. 2025 Apr.

Abstract

Aim: The aim of this improvement collaborative is to explore the variation in care within and between Flemish hospitals in preoperative assessment, surgical indications, perioperative management and surgical technique for ventral mesh rectopexy (VMR).

Method: This observational, cross-sectional multicentre study was performed in 14 Flemish hospitals. Twenty consecutive patients per hospital undergoing primary VMR in 2022 were included. Quality of care was assessed via predefined perioperative disease-specific quality indicators (QIs) by means of structured questionnaires. Data were collected from electronic patient files.

Results: A total of 280 patients were included. All patients were female and their mean age was 62 ± 14 years. Significant intra- and interhospital variation was observed in preoperative work-up, indications, operative technique and postoperative management. Total rectal prolapse was the indication for VMR in only 17.5% of the patients. The surgical approach was minimally invasive in all cases, with 40% via a robotic and 60% a laparoscopic approach. Fifteen per cent of patients had mechanical bowel preparation. All centres used a synthetic polypropylene mesh to perform a VMR, and in 85.6% (n = 238) of all patients a lightweight mesh was used. Diverging practices were noted as to type of mesh fixation to the rectum. In one third of patients a nonresorbable suture was combined with biological glue (n = 89, 31.8%). The overall mean length of stay was 2.1 (± 2.7) days. Only 3% of the procedures were performed as same day discharge, 47% of the patients remained for 1 day and 50% for ≥2 days. Only four patients were readmitted within 30 days after surgery.

Conclusion: This study shows a significant variation in the perioperative management and surgical technique for VMR between hospitals, ongoing controversies and a lack of standardization. This collaborative can serve as a structured feedback tool to define minimum QIs and minimum outcome reporting parameters. Consensus building and adherence to evidence-based guidelines should reduce variation in care processes and lead to improved patient outcomes.

Keywords: colorectal surgery; quality of care; ventral mesh rectopexy.

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References

REFERENCES

    1. D'Hoore A, Cadoni R, Pennickx F. Long‐term outcome of laparoscopic ventral rectopexy for total rectal prolapse. Br J Surg. 2004;91(11):1500–1505. https://doi.org/10.1002/bjs.4779
    1. Cullen J, Rosselli JM, Gurland BH. Ventral rectopexy for rectal prolapse and obstructed defecation. Clin Colon Rectal Surg. 2012;25(1):34–36. https://doi.org/10.1055/s‐0032‐1301757
    1. Lodewijckx C, Sermeus W, Vanhaecht K, Panella M, Deneckere S, Leigheb F, et al. Inhospital management of COPD exacerbations: a systematic review of the literature with regard to adherence to international guidelines. J Eval Clin Pract. 2009;15(6):1101–1110.
    1. Aeyels D, Sinnaeve PR, Claeys MJ, Gevaert S, Schoors D, Sermeus W, et al. Key interventions and quality indicators for quality improvement of STEMI care: a RAND Delphi survey. Acta Cardiol. 2017;73(6):1–10. https://doi.org/10.1080/00015385.2017.1411664
    1. van Zelm R, Janssen I, Vanhaecht K, de Buck van Overstraeten A, Panella M, Sermeus W, et al. Development of a model care pathway for adults undergoing colorectal cancer surgery: evidence‐based key interventions and indicators. J Eval Clin Pract. 2018;24(1):232–239. https://doi.org/10.1111/jep.12700

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