Management of Recurrent Rectal Prolapse: Surgical Approach Influences Outcome

Steele, Scott R.; Goetz, Laura H.; Minami, Shigeki; Madoff, Robert D.; Mellgren, Anders; Parker, Susan C.

doi:10.1007/s10350-005-0315-2

Cited by 87 publications

(71 citation statements)

References 20 publications

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“…Development of recurrent prolapse of the rectum is gradual in most cases. The mean period of time to recurrence ranges between 24 and 33 months with up to one third of cases occurring within the first 7 months after primary repair [4,5].…”

Section: Discussionmentioning

confidence: 99%

“…The risk of recurrence may rise if the muscular and fascial structures of the pelvic floor are not reinforced, if a deep pouch of Douglas is not obliterated, and due to decreased propensity to adhesions between the rectum and the pelvic tissues as well [12]. The ischaemic segment of a bowel should not be left intact in the operating field if another repair with a perineal approach is undertaken in a case of multiple recurrences [4][5][6][7]. The recurrence rate after operations with a perineal approach according to the authors' experience reached 50% of patients.…”

Section: Discussionmentioning

confidence: 99%

“…The recurrence rate after operations with a perineal approach according to the authors' experience reached 50% of patients. For instance, Steele reported a 37.3% rate of relapse [5]. Therefore, an abdominal procedure should be considered until laparotomy is not contraindicated due to poor general condition of a patient.…”

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%

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Management of recurrent rectal prolapse

Kościński¹,

Hermann²,

Banasiewicz³

2013

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“…However, they are associated with higher rates of recurrence. 3,4 Abdominal approaches are associated with lower recurrence rates and improved functional and physiological outcomes. [5][6][7] However, the need of a laparotomy wound represents a potential source of significant mortality and morbidity, which minimizes the role of transabdominal approaches in elderly and debilitated patients.…”

Section: Introductionmentioning

confidence: 99%

Comparison between laparoscopic and open abdominal rectopexy for full-thickness rectal prolapse: controlled clinical trial

Abdelraheem

Singh

2017

Int Surg J

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Background: Abdominal rectopexy is an appropriate treatment option for full-thickness rectal prolapse (FTRP). Our aim is to evaluate the effectiveness and surgical outcome of laparoscopic posterior mesh rectopexy in treatment of FTRP by comparing this procedure with the traditional open approach.Methods: Thirty consecutive cases with FTRP were included and subjected to abdominal posterior mesh rectopexy from September 2013 to February 2016 at Sohag University Hospital. Thirteen patients were managed laparoscopically and 17 patients underwent open posterior mesh repair. Demographic data and surgical outcome were compared in both groups.Results: Laparoscopic group showed an earlier tolerance to oral feeding (1.26±0.42 versus 2.16±1.36 days, p=0.03), and earlier hospital discharge and return to work (5.63±2.91 versus 8.24±4.64 days, p=0.016, 18.28±2.61 versus 28.64±3.82 days, p=0.032, respectively). The mean consumed postoperative analgesics per day was less among laparoscopic group (1.63±16.2 versus 2.68±34.21 ampoule/day, p=0.012). Incidence of wound infection, wound dehiscence, prolonged ileus and postoperative chest infection were more in open group. There were significant postoperative improvement of continence status, rectal bleeding and abdominal pain in each group. Incidence of postoperative constipation was slightly increased in both groups, but without significant difference. Recurrence occurred in one case only in open group. There were no mortalities in both groups.Conclusions: Laparoscopic posterior mesh rectopexy for FTRP can be done safely even in elderly patients. It offers less postoperative pain, low incidence of postoperative morbidities, early hospital discharge and return to work, in addition to cosmetically better outcome. Laparoscopic rectopexy has the same functional outcome as open technique.

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Rectal Prolapse

Mills

2011

The ASCRS Textbook of Colon and Rectal Surgery

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Management of Recurrent Rectal Prolapse: Surgical Approach Influences Outcome

Abstract: The re-recurrence rate after surgery for recurrent rectal prolapse is high, even at a relatively short follow-up interval. Our data suggest that abdominal repair of recurrent rectal prolapse should be undertaken if the patient's risk profile permits this approach.

Cited by 87 publications

References 20 publications

Management of recurrent rectal prolapse

Management of recurrent rectal prolapse

Comparison between laparoscopic and open abdominal rectopexy for full-thickness rectal prolapse: controlled clinical trial

Rectal Prolapse

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