{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T06:09:48Z","timestamp":1769926188739,"version":"3.49.0"},"reference-count":16,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T00:00:00Z","timestamp":1765152000000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Full\u2010thickness rectal prolapse (FTRP) is heterogeneous, with outcomes varying despite similar anatomy. Cooper et\u00a0al. proposed a radiological classification based on prolapse \u2018take\u2010off\u2019 level on defecating proctography (DPG), hypothesising that high take\u2010off (HTO) and low take\u2010off (LTO) phenotypes may respond differently to abdominal versus perineal repair. This hypothesis has not previously been tested in a clinical cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective observational cohort study was performed across three hospitals over 12\u2009years (2012\u20132024). Patients undergoing laparoscopic ventral mesh rectopexy (VMR), as first standardised by D'Hoore et\u00a0al. [3] or Delorme's procedure with DPG\u2010defined take\u2010off were included. Outcomes were compared between procedures, matched versus unmatched surgery, and HTO versus LTO. The primary end\u2010point was anatomical recurrence. Secondary end\u2010points included radiological findings and symptom profiles by phenotype.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 108 patients, 71 (52 VMR, 19 Delorme's) had evaluable DPG and were included in phenotype analysis (HTO,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200928; LTO,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200943). Overall recurrence was 15.5%. Recurrence was lower after VMR than Delorme's (13.5% vs. 21.1%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.47) and in matched versus unmatched surgery (12.8% vs. 20.8%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.53), though not statistically significant. Within VMR, recurrence was lower in HTO than LTO (8.3% vs. 17.9%). HTO was significantly associated with enterocele (71.4% vs. 44.2%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.030) and greater perineal discomfort (85.7% vs. 55.8%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.010), whereas LTO more frequently presented with incontinence\/urgency.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This first clinical validation of the high\/low take\u2010off concept demonstrates phenotype\u2010specific differences in radiology, symptoms, and surgical outcomes. Tailoring surgery to prolapse phenotype may reduce recurrence and guide personalised operative planning. Prospective, multicentre studies with quality\u2010of\u2010life outcomes are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/codi.70330","type":"journal-article","created":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T04:21:39Z","timestamp":1765254099000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["High versus low take\u2010off rectal prolapse: Outcomes of tailored surgery"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4625-0852","authenticated-orcid":false,"given":"Mohit Satish","family":"Gupta","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery University Hospitals Dorset NHS Foundation Trust  Poole UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Usman","family":"Mateen","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery University Hospitals Dorset NHS Foundation Trust  Poole UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Davies","sequence":"additional","affiliation":[{"name":"Department of Surgery Dorset County Hospital NHS Foundation Trust  Dorchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Clarke","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery University Hospitals Dorset NHS Foundation Trust  Poole UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,8]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-004-6465-9"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02053850"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-005-0485-y"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02076191"},{"issue":"11","key":"e_1_2_14_6_1","article-title":"Surgery for complete (full\u2010thickness) rectal prolapse in adults","volume":"2015","author":"Tou S","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151\u2010024\u201003093\u20100"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2012.03135.x"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjsopen\/zrac018"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.13247"},{"issue":"10","key":"e_1_2_14_11_1","first-page":"852","article-title":"Surgical management of full\u2010thickness rectal prolapse: a 10\u2010year experience in a single institution","volume":"16","author":"Maggiori L","year":"2014","journal-title":"Color Dis"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-015-1395-1"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463\u20101318.2009.01891.x"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2008.01626.x"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20102008\u20101075861"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2022.8307"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464\u2010005\u20103012\u20102"}],"container-title":["Colorectal 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