Management of recurrent rectal prolapse

Fengler, Scott A.; Pearl, Russell K.; Prasad, M. Leela; Orsay, Charles P.; Cintron, José; Hambrick, Ernestine; Abcarian, Herand

doi:10.1007/bf02055442

Cited by 59 publications

(34 citation statements)

References 5 publications

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“…16 Unless the previous anastomosis is resected in the second procedure, resection procedures should be avoided to prevent occurrence of ischemic segments of bowel between the two anastomosis that can lead to catastrophic consequences. 17 In conclusion, abdominal and perineal procedures can be safely performed for the treatment of complete rectal prolapse and recurrent rectal prolapse with good results. The best surgical option should be individualized for each patient based upon characteristics such as age, associated medical condition, symptoms of fecal incontinence, or constipation allied with the surgeon's experience.…”

Section: Discussionmentioning

confidence: 82%

Surgical treatment of rectal prolapse: experience and late results with 51 patients

et al. 2004

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The "best" surgical technique for the management of complete rectal prolapse remains unknown. Due to its low incidence, it is very difficult to achieve a representative number of cases, and there are no large prospective randomized trials to attest to the superiority of one operation over another.PURPOSE: Analyze the results of surgical treatment of complete rectal prolapse during 1980 and 2002. METHOD: Retrospective study. RESULTS: Fifty-one patients underwent surgical treatment during this period. The mean age was 56.7 years, with 39 females. Besides the prolapse itself, 33 patients complained of mucous discharge, 31 of fecal incontinence, 14 of constipation, 17 of rectal bleeding, and 3 of urinary incontinence. Abdominal operations were performed in 36 (71%) cases. Presacral rectopexy was the most common abdominal procedure (29 cases) followed by presacral rectopexy associated with sigmoidectomy (5 cases). The most common perineal procedure was perineal rectosigmoidectomy associated with levatorplasty (12 cases). Intraoperative bleeding from the presacral space developed in 2 cases, and a rectovaginal fistula occurred in another patient after a perineal rectosigmoidectomy. There were 2 recurrences after a mean follow-up of 49 months, which were treated by reoperation.CONCLUSION: Abdominal and perineal procedures can be used to manage complete rectal prolapse with safety and good long-term results. Age, associated medical conditions, and symptoms of fecal incontinence or constipation are the main features that one should bear in mind in order to choose the best surgical approach.

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Section: Discussionmentioning

confidence: 82%

Surgical treatment of rectal prolapse: experience and late results with 51 patients

et al. 2004

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“…It is widely accepted that pathophysiological factors regarding treatment of rectal prolapse are taken into account during abdominal methods of operation [3,4,8]. Relapses after abdominal procedures more likely result from technical faults such as the use of absor bable meshes for repair [9,10].…”

Section: Discussionmentioning

confidence: 99%

“…Although the rate of recurrence rises to 50% of patients, on the basis of the literature, there are limited data regarding the possible causal factors of relapse and the treatment options available [3][4][5]. Abdominal fixation of the rectum to the promontory and anterior resection of the rectum and sigmoid colon, or a combination of both, are the most efficient methods of primary treatment of the disease, though in low-risk patients [1].…”

Section: Introductionmentioning

confidence: 99%

Management of recurrent rectal prolapse

Kościński¹,

Hermann²,

Banasiewicz³

2013

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K Ke ey y w wo or rd ds s: : recurrent rectal prolapse, redo surgery, abdominal rectopexy. S Sł ło ow wa a k kl lu uc cz zo ow we e: : nawrotowe wypadanie odbytnicy, operacje wtórne, rektopeksja brzuszna. This study entered 16 patients after redo surgery for recurrent rectal prolapse between 1998 and 2010. There were 14 female and 2 male patients aged from 42 to 92 (mean age 69 years). Primary abdominal rectopexy was performed in 5 patients, 3 patients underwent perineal rectosigmoidectomy, 1 patient had abdominal sigmoidectomy, Delorme procedure was applied in 2 patients, Thiersch encirclement in 4 patients and perineoplasty in 1 patient. There were redo operations for recurrent prolapse as follows: abdominal rectopexy in 7 patients, perineocolporectopexy in 3 females, rectopexy with sigmoidectomy in 2 patients, Altemeier operation in 7 patients and Longo procedure in 1 patient. R Re es su ul lt ts s: : Permanent correction of prolapse was successful in 12 (75%) patients. Following relapses were recognized in 3 patients who underwent Altemeier operation and in 1 patient after the Longo procedure. There were no statistically significant differences regarding faecal incontinence and obstructed defecation between the patients before and after the operation. C Co on nc cl lu us si io on ns s: : Abdominal rectopexy is the method of choice for the treatment of recurrent rectal prolapse. Rectopexy combined with correction of associated anatomical defects of the pelvic floor results in a better functional outcome. Redo operations with the perineal approach are burdened with a high rate of recurrence.

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“…The outcome is generally acceptable. However, fistulotomy causes various degrees of anal sphincter injury [6,[17][18][19][20][21] . The incontinence status is underestimated.…”

Section: Discussionmentioning

confidence: 99%

A anorectal fistula treatment with acellular extracellular matrix: A new technique

Song¹,

Wang²,

Zheng³

et al. 2008

WJG

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AIM:To investigate a new technique of the anorectal fistula treatment with acellular extracellular matrix (AEM). METHODS: Thirty patients with anorectal fistula were treated with AEM. All fistula tracts and primary openings were identified using conventional fistula probe. All tracts were curetted with curet and irrigated with hydrogen peroxide and metronidazole. The AEM was pulled into the fistula tract from secondary to primary opening. The material was secured at the level of the primary opening. The excess AEM was trimmed at skin level at the secondary opening. RESULTS: All of the 30 patients had successful closure of their fistula after a 7-14 d follow-up. The healing rate of anal fistula in treatment group was 100%. The ache time, healing time and anal deformation of treatment group were obviously superior to traditional surgical methods. CONCLUSION: Using AEM anal fistula plug in treatment that causes the anorectal fistula is safe and successful in 100% of patients. It can reduce pain, shorten disease course and protect anal function.

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Management of recurrent rectal prolapse

Cited by 59 publications

References 5 publications

Surgical treatment of rectal prolapse: experience and late results with 51 patients

Surgical treatment of rectal prolapse: experience and late results with 51 patients

Management of recurrent rectal prolapse

A anorectal fistula treatment with acellular extracellular matrix: A new technique

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