Management of infection after prosthetic abdominal rectopexy (Wells' procedure)

Ross, A. H. McL.; Thomson, J. P. S.

doi:10.1002/bjs.1800760629

Cited by 31 publications

(9 citation statements)

References 8 publications

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“…Recently, instead of a non-absorbable sponge, absorbable materials, such as vicryl or dexon, have been used. When absorbable materials are used, the recurrence rate is not higher, and complications, such as pelvic sepsis, are reported to be slightly lower [52]. Complications are mainly affected by the bowel has been resected rather than by the type of prosthetic material.…”

Section: Surgical Treatmentsmentioning

confidence: 99%

Surgical Treatment of Rectal Prolapse

Shin

2011

J Korean Soc Coloproctol

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Rectal prolapse is defined as a protrusion of the rectum beyond the anus. Although rectal prolapse was recognized as early as 1500 BC, the optimal surgical procedure is still debated. The varied operative procedures available for treating rectal prolapsed can be confusing. The aim of treatment is to control the prolapse, restore continence, and prevent constipation or impaired evacuation. In elderly and high-risk patients, perineal approaches, such as Delorme's operation and Altemeier's operation, have been preferred, although the incidence of recurrence and the rate of persistent incontinence seem to be high when compared with transabdominal procedures. Abdominal operations involve dissection and fixation of the rectum and may include a rectosigmoid resection. From the late twentieth century, the laparoscopic procedure has been applied to the treatment of rectal prolapse. Current laparoscopic surgical techniques include suture rectopexy, stapled rectopexy, posterior mesh rectopexy with artificial material, and resection of the sigmoid colon with colorectal anastomosis with or without rectopexy. The choice of surgery depends on the status of the patient and the surgeon's preference.

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Section: Surgical Treatmentsmentioning

confidence: 99%

Surgical Treatment of Rectal Prolapse

Shin

2011

J Korean Soc Coloproctol

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“…Die Infektionsrate betr/igt 1,8-16% ffir die Wells-oder Ripstein-Rektopexie [5,11,32], in unserer Studie wurden 12,5% an Infekten diagnostiziert. Einzig schwerwiegende Infektion ist die pelvine Sepsis mit der Infektion des Rektopexienahtlagermaterials [17,42,47], die neben kardiovaskul/iren Komplikationen vornehmlich die postoperative Mortalit/it bedingt [42,47]. Einzig schwerwiegende Infektion ist die pelvine Sepsis mit der Infektion des Rektopexienahtlagermaterials [17,42,47], die neben kardiovaskul/iren Komplikationen vornehmlich die postoperative Mortalit/it bedingt [42,47].…”

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“…Die /iberwiegende Zahl der infekti6sen Komplikationen kann kurzfristig therapiert werden. unter dem Schutz eines tempor/iren Anus praeter [28,36,42,47]. Die Entfernung des infizierten Kunststoffmaterials ist zur Ausheilung der Infektion zwingend erforderlich; die Entfernung kann transanal, transvaginal, intersphinkt/ir oder abdominal erfolgen, ggf.…”

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Klinische und funktionelle Ergebnisse der abdominalen Rektopexie unter Verwendung verschiedener Fixierungsgrundlagen

Winde

Reers

Holzgreve

et al. 1993

Langenbecks Arch Chir

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We report our results with abdominal rectopexy (modified Ripstein procedure, Ripstein/Corman) without resection of the colon in 63 patients using lyophylized dura-strips, Vicryl gauze or Dexon gauze, as the underlying fixation material for the mobilized rectum, presacral fascia and fixation suture material. Forty-five of 64 patients (71.4%) were reevaluated by proctoscopic examination and questioning; the mean follow-up time was 52.5 months (range 3-136 months). Postoperative mortality due to the method was 0%; the mortality was 1.6% (n = 1/63) in general for the first postoperative 30-day period as a result of cardiac complications. There were three complications (4.7%) the durating operation. Postoperative morbidity was 25.4% (16/63); infectious complications occurred in 12.7% (8/63) of cases, with one case of spontaneous closure of a pelvicutaneous fistula after intraoperative injury to the rectal wall. Full-thickness rectal prolapse appeared after rectopexy in 4.4% (2/45) (dura material alone) and mucosal prolapse was seen in 15.5% (7/45) of the follow-up group. Constipation was reduced by 28.6% (18/63) to 22.2% during the follow-up. Seventeen of 28 patients (60.7%) with incontinence showed an improvement; total continence was registered in 35.7% (10/28). The increase in continence as a result of abdominal rectopexy was significant (Wilcoxon, P = 0.05). The special aspects of being in an older age group, having a long history of procidentia, the number of deliveries, the length of the preoperative incontinence period all showed no influence on the postoperative degree of continence (Spearman's rank correlation). In 7/15 cases with persisting incontinence after rectopexy, postanal repair (Parks) was efficient in 7/7 cases leading to total or partial continence.(ABSTRACT TRUNCATED AT 250 WORDS)

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“…This is due to the increased rates of infection demonstrated in studies utilizing the polyvinyl alcohol sponge. 52,53 The author prefers polypropylene but recognizes that there is no evidence to support its superiority over any others mesh types or suture rectopexy alone. 54 There is a theoretical advantage of suture rectopexy over the repairs utilizing mesh.…”

Section: Abdominal Repairsmentioning

confidence: 99%

Rectal Prolapse

O’Brien

2007

Clinics in Colon and Rectal Surgery

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Despite the innovation of more than 100 surgical procedures for the treatment of complete rectal prolapse, no one procedure is best and applicable to all patients. Traditionally, procedures have been divided into abdominal and perineal approaches. The application of the laparoscopic approach to colon and rectal disease has allowed an additional less invasive method of therapy to treat rectal prolapse successfully. In comparison with conventional approaches, laparoscopy has achieved similar functional results and recurrence rates while reducing postoperative pain and hospital length of stay.

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Management of infection after prosthetic abdominal rectopexy (Wells' procedure)

Cited by 31 publications

References 8 publications

Surgical Treatment of Rectal Prolapse

Surgical Treatment of Rectal Prolapse

Klinische und funktionelle Ergebnisse der abdominalen Rektopexie unter Verwendung verschiedener Fixierungsgrundlagen

Rectal Prolapse

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