Abstract:

Objective

To investigate the surgical effect of laparoscopic pelvic floor repair combined with procedure for prolapse and hemorrhoids （PPH） vs. PPH only in the treatment of internal rectal prolapse （IRP）.

Methods

Clinical data of 122 patients with internal rectal prolapse admitted to the Department of Gastrointestinal Surgery from January 2019 to October 2021 were collected and divided into two groups according to different surgical methods. Among them，sixty-two patients underwent laparoscopic pelvic floor repair combined with PPH as the group A and 60 patients underwent PPH as group B. The Wexner Constipation Scale （WCS），the Wexner Incontinence Scale （WIS），the Degree of Internal Rectal Prolapse （DIRP），and the Gastrointestinal Quality of Life Index （GIQLI） were utilized for the assessment of two patient groups pre-surgery，and at 6-month and 2-year intervals post-surgery. Furthermore，postoperative complications and recurrences at 6 months and 2 years were documented.

Results

No significant variations were observed between the two groups in terms of gender，age，BMI，and preoperative measurements on the WCS，WIS，DIRP，and GIQLI scales （all P＞0.05）. The WCS，WIS，DIRP and GIQLI of the two groups at 6 months and 2 years after surgery were statistically significant （all P＜0.05）. Six months and two years followed the surgery，the observation group showed significantly improved WCS，WIS，DIRP，and GIQLI scores compared to the control group （F=24.445，26.455，58.896，101.355，90.579，115.87，22.893，68.252； all P＜0.001）. No significant differences were observed in Grade I and I～III postoperative complications between the two groups （χ²=0.003，P＞0.05），and the recurrence rate in the observation group was lower than that in the control group at 2 years after operation （χ²=4.481，P＜0.05）.

Conclusion

Laparoscopic pelvic floor repair combined with PPH is effective in the treatment of internal rectal prolapse with low recurrence rate.

Key words: Rectum, Internal rectal prolapse, Repair surgery, Pelvic floor, PPH