A systematic review of the literature on the surgical management of recurrent rectal prolapse

Abstract

This systematic review was unable to develop a treatment algorithm for recurrent rectal prolapse due to the variety of surgical techniques described and the low level of evidence within heterogeneous studies. Larger high-quality studies are necessary to guide practice in this difficult area.

New kid on the block: perineal stapled prolapse resection (PSP) is it worthwhile in the long-term?

“…So, it is not astonishing that patients undergoing PSP show less recurrence if they suffer from a primary prolapse. All the same, a 5-year recurrence-free survival of only 34.3 % is astonishingly low compared to up to 50 % reported in a recent systematic review of other procedures [34]. It remains unclear whether the elevated recurrence rate is only caused by the relatively long time at risk (5 years) or whether PSP is inferior to other procedures in the treatment of recurrent prolapse.…”

“…The diminished recurrence rate in patients without preoperative ODS and in older patients might be caused by the fact that these patients strain less during defecation. Although conclusive studies on the issue are lacking, more pronounced straining is currently considered to be a risk factor for recurrence [34,35]. Even if it is probable that patients having problems to evacuate are at higher risk to suffer from a recurrence after PSP than after abdominal procedures, this cannot be concluded from the literature so far.…”

“…What seems to be clear is that patients suffering from a recurrent prolapse are at a higher risk to develop a recurrence after operative treatment of the prolapse [34]. So, it is not astonishing that patients undergoing PSP show less recurrence if they suffer from a primary prolapse.…”

Rectal prolapse: rare presentation and complication

“…The surgical approach to rectal prolapse has been the topic of much debate in the literature as well. [8][9][10][11] The perineal approach offers a viable surgical approach to high risk patients but with a higher recurrence rate, as opposed to the abdominal approach. 9,12 In the presence of possible rectal ischemia, a perineal rectosigmoidectomy is the only available option, as was in our case.…”

Laparoscopic-Assisted Altemeier’s Procedure for Recurrent Strangulated Rectal Prolapse: A Case Report

“…In fact, recurrence rates up to 50% have been reported [9]. A recent systematic review was unable to propose a treatment algorithm due to the lack of randomized trials, variety of surgical techniques, and heterogeneity within the studies [10]. …”