Gastroenterol Res

Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access

Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc

Journal website https://gr.elmerpub.com

Original Article

Volume 000, Number 000, March 2025, pages 000-000

Comparative Outcomes of Transabdominal and Transperineal Approaches for Full-Thickness Rectal Prolapse Repair: A Fourteen-Year Retrospective Study

Figure 2. Covariate balance evaluation before and after propensity score weighting using inverse probability weighting: Kernel density plot (above) and mean standardized differences (below). “Urgency” refers to any surgical procedure for rectal prolapse performed on a nonelective basis. ASA: American society of anesthesiology; BMI: body mass index.

**Table 1.** Baseline Characteristic of all Patients
Variable, n (%)	Transperineal (n = 33)	Transabdominal (n = 25)	P value
^aMultimorbidity is defined as patients having two or more comorbidities or being bedridden. ^bNumbers of patients were 24 (transperineal) vs. 23 (transabdominal). ^cUrgency refers to any surgical procedure for rectal prolapse performed on a nonelective basis. ASA: American society of anesthesiology; BMI: body mass index; OR: operating room; IQR: interquartile range; SD: standard deviation.
Age (year), mean (SD)	72.0 (12.1)	68.5 (9.7)	0.233
Male	8 (24.2)	3 (12.0)	0.320
Multimorbidity^a	11 (33.3)	2 (8.0)	0.028
Bedridden	4 (12.1)	0 (0)	0.126
ASA III	17 (51.5)	9 (36.0)	0.451
BMI^b, mean (SD)	21.4 (4.0)	20.6 (3.5)	0.463
Urgency^c cases	12 (36.4)	1 (4.0)	0.004
OR time (min), mean (SD)	52.3 (33.0)	77.4 (35.1)	0.007
Blood loss (mL), median (IQR)	50 (0, 100)	50 (10, 100)	0.818
Follow-up time (months), mean (SD)	21.2 (32.7)	28.3 (29.9)
≥ 1 year follow-up	18 (54.6)	16 (64.0)
Outcomes
Complication	2 (6.1)	1 (4.0)	> 0.999
Recurrence	4 (12.1)	2 (8.0)	0.690
Constipation	9 (27.3)	8 (32.0)	0.775
Fecal incontinent	12 (36.4)	6 (24.0)	0.396
Hospital stays (day), median (IQR)	3 (2, 4)	4 (3, 6)	0.037

Table 1. Baseline Characteristic of all Patients

Variable, n (%)

Transperineal (n = 33)

Transabdominal (n = 25)

P value

^aMultimorbidity is defined as patients having two or more comorbidities or being bedridden. ^bNumbers of patients were 24 (transperineal) vs. 23 (transabdominal). ^cUrgency refers to any surgical procedure for rectal prolapse performed on a nonelective basis. ASA: American society of anesthesiology; BMI: body mass index; OR: operating room; IQR: interquartile range; SD: standard deviation.

Age (year), mean (SD)

72.0 (12.1)

68.5 (9.7)

0.233

Male

8 (24.2)

3 (12.0)

0.320

Multimorbidity^a

11 (33.3)

2 (8.0)

0.028

Bedridden

4 (12.1)

0 (0)

0.126

ASA III

17 (51.5)

9 (36.0)

0.451

BMI^b, mean (SD)

21.4 (4.0)

20.6 (3.5)

0.463

Urgency^c cases

12 (36.4)

1 (4.0)

0.004

OR time (min), mean (SD)

52.3 (33.0)

77.4 (35.1)

0.007

Blood loss (mL), median (IQR)

50 (0, 100)

50 (10, 100)

0.818

Follow-up time (months), mean (SD)

21.2 (32.7)

28.3 (29.9)

≥ 1 year follow-up

18 (54.6)

16 (64.0)

Outcomes

Complication

2 (6.1)

1 (4.0)

> 0.999

Recurrence

4 (12.1)

2 (8.0)

0.690

Constipation

9 (27.3)

8 (32.0)

0.775

Fecal incontinent

12 (36.4)

6 (24.0)

0.396

Hospital stays (day), median (IQR)

3 (2, 4)

4 (3, 6)

0.037

**Table 2.** Comparative Outcomes Between Transperineal and Transabdominal Complete Rectal Prolapse Repair With Inverse Probability Weighting Propensity Score Analysis
Outcomes	The study outcomes	Sensitivity analysis
During analysis, the transabdominal approach was treated as the intervention. The risk ratios should be interpreted accordingly (e.g., a lower risk ratio for recurrence indicates a lower recurrence rate for the transabdominal approach, and vice versa). ^aMore than 1-year follow-up: 18 transperineal vs. 16 transabdominal repairs. ^bMultimorbid model: replacing the American Society of Anesthesiology III status with the multimorbidity variable (defined as patients having two or more comorbidities or being bedridden) for propensity score calculation. CI: confidence interval; SE: standard error.
Complication	0.67 (0.06, 7.65)	0.83	0.749	1.18 (0.07, 19.88)	1.70	0.907	0.67 (0.06, 7.75)	0.84	0.748
Recurrence	0.62 (0.11, 3.53)	0.55	0.592	0.91 (0.13, 6.46)	0.91	0.927	0.56 (0.10, 3.21)	0.50	0.511
Constipation	0.85 (0.33, 2.19)	0.41	0.733	2.24 (0.61, 8.19)	1.48	0.223	1.01 (0.37, 2.78)	0.52	0.988
Fecal incontinent	0.59 (0.23, 1.57)	0.29	0.293	0.50 (0.16, 1.60)	0.30	0.244	0.44 (0.16, 1.23)	0.23	0.116
Hospital stays (day difference)	0.02 (-2.09, 2.13)	1.05	0.984	-0.89 (-5.38, 3.61)	2.19	0.689	0.16 (-1.81, 2.14)	0.99	0.869

Table 2. Comparative Outcomes Between Transperineal and Transabdominal Complete Rectal Prolapse Repair With Inverse Probability Weighting Propensity Score Analysis

Outcomes

The study outcomes

Sensitivity analysis

Full-model (n = 58)

More than 1-year follow-up^a

Multimorbid model^b

Risk ratio (95% CI)

During analysis, the transabdominal approach was treated as the intervention. The risk ratios should be interpreted accordingly (e.g., a lower risk ratio for recurrence indicates a lower recurrence rate for the transabdominal approach, and vice versa). ^aMore than 1-year follow-up: 18 transperineal vs. 16 transabdominal repairs. ^bMultimorbid model: replacing the American Society of Anesthesiology III status with the multimorbidity variable (defined as patients having two or more comorbidities or being bedridden) for propensity score calculation. CI: confidence interval; SE: standard error.

Complication

0.67 (0.06, 7.65)

0.83

0.749

1.18 (0.07, 19.88)

1.70

0.907

0.67 (0.06, 7.75)

0.84

0.748

Recurrence

0.62 (0.11, 3.53)

0.55

0.592

0.91 (0.13, 6.46)

0.91

0.927

0.56 (0.10, 3.21)

0.50

0.511

Constipation

0.85 (0.33, 2.19)

0.41

0.733

2.24 (0.61, 8.19)

1.48

0.223

1.01 (0.37, 2.78)

0.52

0.988

Fecal incontinent

0.59 (0.23, 1.57)

0.29

0.293

0.50 (0.16, 1.60)

0.30

0.244

0.44 (0.16, 1.23)

0.23

0.116

Hospital stays (day difference)

0.02 (-2.09, 2.13)

1.05

0.984

-0.89 (-5.38, 3.61)

2.19

0.689

0.16 (-1.81, 2.14)

0.99

0.869