Outcomes of the Gant-Miwa-Thiersch Procedure Using the Leeds-Keio Mesh for Rectal Prolapse

Abstract

Objectives: Several procedures are available for treating rectal prolapse (RP). This study aimed to determine the effectiveness of the Gant-Miwa-Thiersch (GMT) procedure using the Leeds-Keio mesh (LKM) as a treatment for RP.

Methods: This retrospective observational study included all patients with RP who underwent the GMT procedure using the LKM at our hospital between January 2012 and December 2023. The surgery was performed under local or lumbar spinal anesthesia in the jackknife position. The outcome measures included perioperative complications, recurrence rate, and improvement in anal function.

Results: During the study period, 107 patients with RP underwent the GMT procedure. The median patient age was 81 years, the median length of prolapse was 7 cm, and the median duration of the surgery was 39 minutes. Postoperative complications were observed in 26 (24.3%) patients, including constipation in 21, mesh early exposure in three, mesh infection in one, and bleeding in one patient(s). The median observation period was 29 months, and recurrence of RP was observed in nine (10%) out of 90 patients evaluated for recurrence, with a cumulative 5-year recurrence rate of 10.9%. Of the 65 patients with preoperative fecal incontinence, 33 (50.8%) demonstrated improvement postoperatively.

Conclusions: The GMT procedure using the LKM has a low recurrence rate. The LKM is suitable as a prosthetic material for the Thiersch procedure due to its high elasticity, which can enhance the therapeutic efficacy of the GMT procedure.