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Anatomo-functional outcomes of the laparoscopic Frykman–Goldberg procedure for rectal prolapse in a tertiary referral centre

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Abstract

Rectal prolapse is a common disorder that represents a burden for patients due to the associated symptoms that may include both incontinence and constipation. Currently, a huge variation in techniques exist. The aim of this study was to evaluate the anatomo-functional results of the laparoscopic Frykman–Goldberg procedure (LFGP) for the treatment of both internal (IRP) and complete rectal prolapse (CRP). Between July 2004 and October 2019, 45 patients with IRP and CRP underwent a LFGP. The Cleveland Clinic Constipation Score (CCCS), Obstructed Defecation Syndrome Score (ODSS) and Vaizey Score (VS) were assessed preoperatively, 3 months before the procedure, 12 months after the procedures and at the final follow-up visit. The patients’ mean age was 51.4 ± 17.9 (15–93) years, and the mean follow-up was 9.24 ± 4.57 (1.6–16.3) years. The VS, CCCS and ODSS significantly improved (p = 0.008; p < 0.001; p < 0.001) from median preoperative values of 3, 20 and 18 to 2, 6 and 5, respectively. Furthermore, the improvements in scores during follow-up remained constant and significant over time when considering the two groups separately (time effect for ODSS p < 0.001, for VS p = 0.026, for CCCS p < 0.001) and when the patients were divided by age (< 40, 41–60 and > 60; p < 0.001). The overall complication rate was 8.9% (4/45), and no intraoperative complications or anastomotic leakage occurred. Conversion to the open approach was not necessary in any case. The overall success rate was 97.7%, and only one recurrence in the IRP group occurred after 14 months. LRGP can be considered a safe, effective and long-lasting procedure in young patients with IRP or CRP, a history of ODS and a redundant sigmoid colon.

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Author notes

  1. Gaetano Gallo and Mario Trompetto shared first author position.

  2. Alberto Realis Luc, Giuseppe Clerico and Giuseppe Sammarco contributed equally to this work.

Authors and Affiliations

  1. Department of Medical and Surgical Sciences, University of Catanzaro, 88100, Catanzaro, Italy

    Gaetano Gallo & Gilda De Paola

  2. Department of Colorectal Surgery, S. Rita Clinic, 13100, Vercelli, Italy

    Gaetano Gallo, Mario Trompetto, Alberto Realis Luc & Giuseppe Clerico

  3. Biostat Research s.a.s, 28021, Borgomanero, Italy

    Eugenio Novelli

  4. Department of Health Sciences, University of Catanzaro, 88100, Catanzaro, Italy

    Giuseppe Sammarco

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  1. Gaetano Gallo
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Correspondence to Gaetano Gallo.

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This study was approved by our local ethics committee and written informed consent was obtained from all patients. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

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Gallo, G., Trompetto, M., Realis Luc, A. et al. Anatomo-functional outcomes of the laparoscopic Frykman–Goldberg procedure for rectal prolapse in a tertiary referral centre. Updates Surg 73, 1819–1828 (2021). https://doi.org/10.1007/s13304-021-01114-3

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