***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background The objective of this study was to measure the change in colonic transit time after resection rectopexy for complete rectal prolapse . Methods We prospect ively carried out isotope colonic transit studies before resection rectopexy in 38 patients with full-thickness complete rectal prolapse and invited them to attend for a postoperative transit study at least 1 year after resection rectopexy . Results Preoperatively , 27 ( 70 % ) patients had abnormally prolonged colonic transit times , while 11 had normal colonic transit . Twenty-two ( 61 % ) patients agreed to attend for a three-day colonic transit study . Resection rectopexy failed to correct delayed colonic transit in all patients with abnormal preoperative tests , while 4 patients developed new delayed transit and 2 with normal transit were unchanged . Conclusions The study suggests that most prolapse patients have a pan-colonic motility disorder that is not corrected by rectopexy and resection of most of the left colon . If resection rectopexy fails to correct abnormal transit , this study questions the rationale for continuing to offer resection and supports less invasive surgical procedures such as ventral rectopexy The objectives of this study were to compare both subjective clinical outcomes and the objective stress response of laparoscopic and open abdominal rectopexy in patients with full‐thickness rectal prolapse .  Abdominal rectopexy for patients with rectal prolapse is well suited for a laparoscopic approach as no resection or anastomosis is necessary BACKGROUND A novel technique of radiofrequency ablation and plication of the rectal mucosa ( RAMP ) as a treatment for rectal mucosal prolapse is reported . The results of this technique are compared with the conventional ligature and excision procedure ( LEP ) . METHODS Radiofrequency ablation was performed using an Ellman radiofrequency generator .  Patients with rectal mucosal prolapse were r and omized to undergo either LEP or RAMP .  The intra- and postoperative outcomes and complications were recorded . RESULTS RAMP on average result ed in reduced operation time , shorter hospitalization , and significantly less postoperative pain . Return to work was earlier and wound healing times were shorter than that of patients in the control group . The complication rates also were significantly shorter ( 9 % in the RAMP group and 29 % in the conventional LEP group ) . CONCLUSION The procedure of radiofrequency ablation and plication of rectal mucosa is safe , effective , and swift . It can be proposed as an effective alternative to conventional surgical procedures Background More than 100 surgical approaches to treat rectal prolapse have been described . These can be done through the perineum or transabdominally . Delorme ’s procedure is the most frequently used perineal , resection rectopexy the most commonly used abdominal procedure . Recurrences seem more common after perineal compared to abdominal techniques , but the latter may carry a higher risk of peri- and postoperative morbidity and mortality . Methods / Design DeloRes is a r and omized , controlled , observer-blinded multicenter trial with two parallel groups . Patients with a full-thickness rectal prolapse ( third degree prolapse ) , considered eligible for both operative methods are included . The primary outcome is time to recurrence of full-thickness rectal prolapse during the 24 months following primary surgery . Secondary endpoints are time to and incidence of recurrence of full-thickness rectal prolapse during the 5-year follow-up , duration of surgery , morbidity , hospital stay , quality of life , constipation , and fecal incontinence . A meta- analysis was done on the basis of the available data on recurrence rates from 17 publications comprising 1,140 patients . Based on the results of a meta- analysis it is assumed that the recurrence rate after 2 years is 20 % for Delorme ’s procedure and 5 % for resection rectopexy . Considering a rate of lost to follow-up without recurrence of 30 % a total of 130 patients ( 2 x 65 patients ) was calculated as an adequate sample size to assure a power of 80 % for the confirmatory analysis . Discussion The DeloRes Trial will clarify which procedure results in a smaller recurrence rate but also give information on how morbidity and functional results compare . Trial registration German Clinical Trial Number BACKGROUND : No r and omized controlled trial has compared no rectopexy with rectopexy for external full-thickness rectal prolapse . OBJECTIVE : This study was performed to test the hypothesis that recurrence rates following no rectopexy are not inferior to those following rectopexy for full-thickness rectal prolapse . DESIGN : This was a multicenter r and omized controlled trial . Eligible patients were r and omly assigned to no rectopexy or rectopexy . The end point was recurrence rates defined as the presence of external full-thickness rectal prolapse after surgery . A prer and omized controlled trial meta- analysis suggested a sample size of 251 patients based on a 15 % expected difference in the 5-year cumulative recurrence rate . Recurrence-free curves were generated and compared using the Kaplan-Meier method and log-rank test , respectively . Data were presented as median ( range ) . SETTING : This study was conducted in 41 tertiary centers in 21 countries . PATIENTS : Patients with prior surgery for rectal prolapse or pelvic floor descent were not included . INTERVENTIONS : The no-rectopexy arm was defined as abdominal surgery with rectal mobilization only . The rectopexy arm was defined as abdominal surgery with mobilization and rectopexy . Sigmoid resection was not r and omized and was added in the presence of constipation . MAIN OUTCOME MEASURES : Two hundred fifty-two patients with external full-thickness rectal prolapse were r and omly assigned to undergo no rectopexy or rectopexy in 41 centers . All patients but one underwent the allocated intervention . One hundred sixteen  no-rectopexy patients were comparable to 136 rectopexy  patients for age ( P = .21 ) , body mass index ( P = .61 ) , ASA grade ( P = .29 ) , and previous abdominal surgery ( P = .935 ) , but not for sex ( P = .013 ) and external full-thickness rectal prolapse length ( 8 ( 1 - 25 ) cm vs 5 ( 1 - 20 ) cm , P = .026 ) .  Sigmoid resection  was performed more frequently in the no-rectopexy arm ( P < .001 ) . There was no significant difference in complication rates ( 11 % vs 17.9 % ; P = .139 ) . The mortality rate was 0.8 % . The loss of patients to 5-year follow-up was 10.3 % . Actuarial analysis demonstrated a significant difference in 5-year recurrence rates between study arms ( 8.6 % vs 1.5 % ) ( log-rank , P = .003 ) . LIMITATIONS : Limitations were the high proportion of male patients , r and omization timing , the lack of st and ardization for rectopexy technique , and the 10 % loss to follow-up . CONCLUSIONS : Recurrence rates following no rectopexy are inferior to those following rectopexy for external full-thickness rectal prolapse The introduction of new laparoscopic techniques has important cost implication s. The aim of this study was to compare the cost effectiveness of laparoscopic rectopexy with that of open abdominal rectopexy for full‐thickness rectal prolapse BACKGROUND Rectal prolapse is a distressing and socially disabling condition . controversy exists regarding the preferred surgical technique for the treatment of complete rectal prolapse . OBJECTIVE We compared Delorme operation alone or with postanal repair and levatroplasty in treating complete rectal prolapse . METHODS Consecutive patients treated for rectal prolapse at our colorectal unit were evaluated for inclusion . Participants were r and omly allocated to receive Delorme operation only ( GI ) , or Delorme operation with postanal repair and levatorplasty ( GII ) . MAIN OUTCOME MEASURES The primary outcome measure was recurrence rate ; secondary outcomes included improvement of constipation , incontinence , operative time , anal manometery and postoperative complications . RESULTS Eighty-two consecutive patients with rectal prolapse were r and omized . There was a significant difference between the two groups with longer operative time in group II . Recurrence rate after one year was ( 14.28 % in GI , and 2.43 % in GII , respectively ( P = 0.043 ) . Constipation improved in group I & II but there was a significant difference in constipation scores postoperatively between the two groups . There was improvement in continence mechanism in both groups postoperatively but being higher in group II and this produce a significant statistical difference ( 0.004 ) . Mean satisfaction score was significantly higher in group II than group I. Both groups succeed to produce a significant change in resting and squeeze pressure before & after the operation . CONCLUSIONS Delorme operation seems to be an effective procedure for treating complete rectal prolapse especially if combined with postanal repair and levatorplasty . CLINICAL TRIAL REGISTRATION NCT01656369 A r and omized trial was performed to compare abdominal resection rectopexy and pelvic floor repair ( n = 10 ) with perineal rectosigmoidectomy and pelvic floor repair ( n = 10 ) in elderly female patients with full‐thickness rectal prolapse and faecal incontinence . There were no recurrences of full‐thickness prolapse following resection rectopexy but one after rectosigmoidectomy .  Continence to liquid and solid stool was achieved in nine patients , with faecal soiling reported in only two , after resection rectopexy and in eight , with soiling in six , following rectosigmoidectomy .  The median ( range ) frequency of defaecation was only 1 ( 1–3 ) per day following resection rectopexy compared with 3 ( 1–6 ) per day after rectosigmoidectomy . There was an increase in the mean(s.d . ) maximum resting pressure after resection rectopexy ( 19.3(15.28 ) cmH2O ) compared with a reduction following rectosigmoidectomy ( – 3.4(13.75 ) cmH2O ) ( P = 0.003 ) . Mean(s.d . ) compliance was also greater after resection rectopexy than following rectosigmoidectomy ( 3.9(0.75 ) versus 2.2(0.78 ) ml/cmH2O , P<0.001 ) . Abdominal resection rectopexy gives better functional and physiological results than perineal rectosigmoidectomy Denervation of the rectum during rectopexy has been suggested as a reason for  postoperative constipation .  Bowel symptoms and anorectal function have been examined in a prospect i ve r and omized study of rectopexy with  ( n = 14 ) or without  ( n = 12 )  division of the lateral ligaments .  Incontinence improved in both groups of patients .  Division of the lateral ligaments increased the number of patients with constipation ( three before operation , ten after operation , P<0.01 ) . Mean anal canal pressures were higher after operation in all patients . Rectal electrical sensory threshold increased significantly in those in whom the ligaments had been divided ( preoperative 27.6 mA versus postoperative 56.7mA ; P<0.01 ) but not in those in whom they were preserved ( 39.0 versus 34.9 mA ; P>0.05 ) . Prolapse recurred in six patients who did not undergo  division of the lateral ligaments , but in none of the group in whom the ligaments were divided OBJECTIVE To compare the efficacy of absorbable and non-absorbable mesh for rectal fixation in abdominal rectopexy . DESIGN Prospect i ve open study . SETTING University hospital , Israel . SUBJECTS 37 consecutive patients with complete rectal prolapse . INTERVENTIONS Posterior abdominal rectopexy with non-absorbable mesh ( Polypropylene , Prolene , Ethicon Ltd ) in 17 patients and with absorbable mesh ( Polyglycolic acid , Dexon , Davis & Geck ) in 20 . MAIN OUTCOME MEASURES There was no operative mortality , and there were no significant differences between the groups in the incidence of postoperative complications . Mean ( SD ) follow up was 3.6(0.5 ) years and 3.8(0.7 ) years in the Dexon and Prolene groups , respectively . Preoperative and postoperative performance indices based on the Gastrointestinal Quality of Life Index were similar in both groups . CONCLUSIONS Dexon mesh may be as effective as Prolene mesh in the treatment of complete rectal prolapse . A performance index seems to be a useful tool for evaluating the outcome of patients after repair of complete rectal prolapse BACKGROUND Laparoscopic ventral mesh rectopexy for rectal prolapse has been widely used over the past decade to reduce postoperative functional bowel disorders . We aim ed to compare changes in functional outcome 12 months after laparoscopic ventral mesh rectopexy versus laparoscopic posterior sutured rectopexy in patients with rectal prolapse . METHODS In this double-blind , r and omised trial , consecutive patients aged 18 years or older at a single centre in Denmark with full-thickness rectal prolapse were r and omly assigned ( 1:1 ) to either laparoscopic ventral mesh rectopexy or laparoscopic posterior sutured rectopexy by drawing numbers from opaque envelopes , in blocks of four for patients with or without preoperative constipation . Functional assessment was done preoperatively and 12 months postoperatively . The primary outcome was preoperative-to-postoperative change in obstructed defecation syndrome ( ODS ) score . Patients and those assessing the outcomes were masked to the procedure . The primary analysis was done in the per- protocol population . Safety outcomes were assessed in the entire cohort . The trial is registered with Clinical Trials.gov , number NCT0094 
    Output:
    
There were no detectable differences between the methods used for fixation during rectopexy .
Division , rather than preservation , of the lateral ligaments was associated with less recurrent prolapse but more postoperative constipation .
Laparoscopic rectopexy was associated with fewer postoperative complications and shorter hospital stay than open rectopexy .
Bowel resection during rectopexy was associated with lower rates of constipation .
Recurrence of full-thickness prolapse was greater for mobilisation of the rectum only compared with rectopexy .
There were no differences in quality of life for patients who underwent the different kinds of prolapse surgery .
It is impossible to identify or refute clinical ly important differences between the alternative surgical operations .