Robotic versus laparoscopic ventral mesh rectopexy: a systematic review and meta-analysis

Abstract Background Ventral mesh rectopexy (VMR) is a widely accepted surgical treatment for rectal prolapse. Both synthetic and biologic mesh are used. No consensus exists on the preferred type of mesh material. The aim of this systematic review and meta-analysis was to establish an overview of the current literature on mesh-related complications and recurrence after VMR with synthetic or biologic mesh to aid evidence-based decision making in preferred mesh material. Methods A systematic search of the electronic databases of PubMed, Embase and Cochrane was performed (from inception until September 2020). Studies evaluating patients who underwent VMR with synthetic or biologic mesh were eligible. The MINORS score was used for quality assessment. Results Thirty-two studies were eligible after qualitative assessment. Eleven studies reported on mesh-related complications including 4001 patients treated with synthetic mesh and 762 treated with biologic mesh. The incidence of mesh-related complications ranged between 0 and 2.4% after synthetic versus 0–0.7% after biologic VMR. Synthetic mesh studies showed a pooled incidence of mesh-related complications of 1.0% (95% CI 0.5–1.7). Data of biologic mesh studies could not be pooled. Twenty-nine studies reported on the risk of recurrence in 2371 synthetic mesh patients and 602 biologic mesh patients. The risk of recurrence varied between 1.1 and 18.8% for synthetic VMR versus 0–15.4% for biologic VMR. Cumulative incidence of recurrence was found to be 6.1% (95% CI 4.3–8.1) and 5.8% (95% CI 2.9–9.6), respectively. The clinical and statistical heterogeneity was high. Conclusions No definitive conclusions on preferred mesh type can be made due to the quality of the included studies with high heterogeneity amongst them.

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Corrigendum: Correction of the Fourth Author's Affiliation. Synthetic Versus Biological Mesh-Related Erosion After Laparoscopic Ventral Mesh Rectopexy: A Systematic Review

Annals of Coloproctology ◽

10.3393/ac.2017.33.6.253 ◽

2017 ◽

Vol 33 (6) ◽

pp. 253-253

Author(s):

Andrea Balla ◽

Silvia Quaresima ◽

Sebastian Smolarek ◽

Mostafa Shalaby ◽

Giulia Missori ◽

...

Keyword(s):

Systematic Review ◽

Biological Mesh ◽

Laparoscopic Ventral Mesh Rectopexy ◽

Fourth Author ◽

Ventral Mesh Rectopexy ◽

Mesh Rectopexy

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Suture rectopexy versus ventral mesh rectopexy for complete full-thickness rectal prolapse and intussusception: systematic review and meta-analysis

BJS Open ◽

10.1093/bjsopen/zraa037 ◽

2021 ◽

Vol 5 (1) ◽

Author(s):

H S Lobb ◽

C C Kearsey ◽

S Ahmed ◽

R Rajaganeshan

Keyword(s):

Systematic Review ◽

Rectal Prolapse ◽

Recurrence Rate ◽

Meta Analysis ◽

Cochrane Library ◽

Complete Rectal Prolapse ◽

Recurrence Rates ◽

Suture Rectopexy ◽

Ventral Mesh Rectopexy ◽

Mesh Rectopexy

Abstract Background This systematic review and meta-analysis aimed to compare recurrence rates of rectal prolapse following ventral mesh rectopexy (VMR) and suture rectopexy (SR). Methods MEDLINE, Embase, and the Cochrane Library were searched for studies reporting on the recurrence rates of complete rectal prolapse (CRP) or intussusception (IS) after SR and VMR. Results were pooled and procedures compared; a subgroup analysis was performed comparing patients with CRP and IS who underwent VMR using biological versus synthetic meshes. A meta-analysis of studies comparing SR and VMR was undertaken. The Methodological Items for Non-Randomized Studies score, the Newcastle–Ottawa Scale, and the Cochrane Collaboration tool were used to assess the quality of studies. Results Twenty-two studies with 976 patients were included in the SR group and 31 studies with 1605 patients in the VMR group; among these studies, five were eligible for meta-analysis. Overall, in patients with CRP, the recurrence rate was 8.6 per cent after SR and 3.7 per cent after VMR (P < 0.001). However, in patients with IS treated using VMR, the recurrence rate was 9.7 per cent. Recurrence rates after VMR did not differ with use of biological or synthetic mesh in patients treated for CRP (4.1 versus 3.6 per cent; P = 0.789) and or IS (11.4 versus 11.0 per cent; P = 0.902). Results from the meta-analysis showed high heterogeneity, and the difference in recurrence rates between SR and VMR groups was not statistically significant (P = 0.76). Conclusion Although the systematic review showed a higher recurrence rate after SR than VMR for treatment of CRP, this result was not confirmed by meta-analysis. Therefore, robust RCTs comparing SR and biological VMR are required.

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