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FOAM: Functional Outcome After Ventral Mesh Rectopexy

Not yet recruiting
Conditions
Rectal Prolapse
Registration Number
NCT06455501
Lead Sponsor
Uppsala University
Brief Summary

Rectal prolapse is a protrusion of rectal wall through the anus. A surgical technique called Ventral mesh rectopexy has become a standard procedure for this condition in many centers.

The goal of this trial is to investigate functional outcome, recurrence rates and complications after ventral mesh rectopexy. The main question it aims to answer is:

- Do bowel function, quality of life and sexual function improve after Ventral mesh rectopexy?

Participants will:

* be asked to fill in questionaires before surgery, 3-6 months after surgery and 12 months after surgery.

* be examined by a surgeon 3-6 months, 12 months and 3 years after surgery.

Detailed Description

Several different procedures have been described for surgical treatment of rectal prolapse and a consensus has not yet been reached. Over the past 20 years, the use of Ventral mesh rectopexy to treat external rectal prolapse has gained increasing worldwide acceptance. Ventral mesh rectopexy has become a standard procedure in many centers based on low recurrence rates, limited complications and good functional results but the use and type of mesh have been debated. Concerns have also been expressed regarding the choice of surgical technique, which differs between centers, and the lack of high-level evidence.

There are few prospective trials and the use of LVMR in a Swedish setting has not yet been evaluated. FOAM (Functional Outcome After ventral Mesh rectopexy) therefore aims to investigate bowel function, quality of life, sexual function, recurrence rates and complications after ventral mesh rectopexy.

A prospective cohort study on patients undergoing ventral mesh rectopexy for external rectal prolapse in Sweden will be conducted. Approximately 70 patients will be included at a maximum of 10 hospitals in Sweden.

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
70
Inclusion Criteria
  • full-thickness rectal prolapse
  • the surgeon agrees that ventral mesh rectopexy is needed for the condition
  • capable of participating in follow-up visits and answering questionnaires
  • informed consent
Exclusion Criteria
  • patient below 18 years of age
  • ongoing pregnancy
  • inability to understand the Swedish language
  • dementia or other cognitive disorder that unables informed consent

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Sexual functionEvaluated at baseline, 3-6 months and 12 months postoperatively

PROMIS Sexual function and satisfaction version 2.0. Selected domains: Interest in sexual activity (scale 2-10, 10=highest interest), sexual activity screener (scale yes/no) and satisfaction with sex life (scale 2-10, 10=highest satisfaction)

Quality of Life after surgeryEvaluated at baseline, 3-6 months and 12 months postoperatively

Colorectal-Anal Impact Questionnaire (CRAIQ-7): scale 0-100, 100=worst outcome

Bowel functionEvaluated at baseline, 3-6 months and 12 months postoperatively

Colo-rectal-anal Distress Inventory (CRADI-8): scale 0-100 (100=worst outcome)

Secondary Outcome Measures
NameTimeMethod
MortalityWithin 30 days postoperatively

30-day mortality

Postoperative complicationsWithin 30 days postoperatively

Clavien Dindo classification

Length of stayFrom day of operation to day of discharge from hospital, reported at follow-up 3-6 months postoperatively.

Stay in hospital postoperatively

Long-term complicationsEvaluated at baseline, 3-6 months, 12 months and 3 years postoperatively.

Ileus, pelvic abscess, mesh erosion, other complications

Recurrence rateEvaluated at baseline, 3-6 months, 12 months and 3 years postoperatively. Clinical examination by surgeon will be performed to evaluate recurrence.

Recurrence of rectal prolapse

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