Abdominal rectopexy with sigmoidectomy vs. rectopexy alone for rectal prolapse: A prospective, randomized study

Abstract

A prospective, randomized study comparing abdominal rectopexy and sigmoid resection (Group I; n = 15) with polyglycolic acid mesh rectopexy without sigmoidectomy (Group II; n = 15) for complete rectal prolapse was carried out. One patient in Group I died of myocardial infarction, one patient in Group II had a small bowel obstruction and two patients in Group I an asymptomatic stricture of the anastomosis. Otherwise a safe and efficient control of the prolapse was achieved in both groups. Eleven (73%) patients in Group I and 12 (80%) patients in Group II were more or less incontinent before surgery. After correction of prolapse incontinence improved in eight and ten patients in Groups I and II, but became slightly worse in one patient in Group II. A similar rise in anal pressures was measured in both groups after surgery. Constipation disappeared in three and seven patients in Groups I and II six months after surgery, but five additional patients in Group II became severely constipated and colectomy had to be performed in one of them. Surgery caused no significant change in colonic transit times even though increased transit times were measured in each group six months postoperatively. Sigmoid resection in conjunction with rectopexy does not seem to increase operative morbidity but tends to diminish postoperative constipation possibly by causing less outlet obstruction.

Perineal Stapled Prolapse Resection

“…The addition of sigmoidectomy to the operation was felt to be associated with a lower recurrence rate and improved functional outcome with a minimal increase in morbidity [23,24]. It seems to reduce constipation significantly in those who report this symptom preoperatively in some studies [23,25,26]. However, in our study, none of the patient had worsening or new onset of constipation in the postoperative period.…”

“…Fifteen percent of patients experience constipation for the first time following rectopexy, and at least 50 % of those who are constipated preoperatively are made worse [22]. The addition of sigmoidectomy to the operation was felt to be associated with a lower recurrence rate and improved functional outcome with a minimal increase in morbidity [23,24]. It seems to reduce constipation significantly in those who report this symptom preoperatively in some studies [23,25,26].…”

Efficacy of Cranial Electrotherapy Stimulation Combined with Biofeedback Therapy in Patients with Functional Constipation

“…Rectal sensations are transported by both parasympathetic and sympathetic afferent nerves. 54 It depends on receptors located in the rectal wall, as well as in the pelvic floor. 55 CES can increase the secretion of the neurotransmitter acetylcholine which is an excitatory neurotransmitter for the digestive tract.…”

Tiesiosios žarnos prolapsas: chirurginis perinealinis gydymas

“…Currently, a way of comprehensive evaluation of pelvic compartments is through the realization of a dynamic pelvic MRI, offering information of urogenital pathologies of the pelvic floor as rectoceles, enteroceles, perineal descent syndrome, paradoxical puborectal muscle contraction, liable to simultaneous surgical correction if the case so warrants [9]. More than 100 different procedures to solve this problem have been documented [10][11][12][13][14][15]. To resolve this problem, options approach abdominal and perineal surgical treatment.…”