Perineal resectional procedures for the treatment of complete rectal prolapse: A systematic review of the literature

Emile, Sameh Hany; Elfeki, Hossam; Shalaby, Mostafa; Sakr, Ahmad; Sileri, Pierpaolo; Wexner, Steven D.

doi:10.1016/j.ijsu.2017.09.005

Cited by 44 publications

(48 citation statements)

References 56 publications

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“…In this study, the outcomes of the perineal group underscore the high recurrence rates generally reported with longer term follow‐up, which contrasts substantially with the results of the PROSPER trial . Recurrence rates after DR have been reported to range from 0% to 38% . Hoel et al reported almost 100% recurrence within 2 years of undergoing DR .…”

Section: Discussionmentioning

confidence: 59%

“…In another study by Ris et al , the recurrence rate after PR was 14% at 4 years . Published recurrence rates vary from 0% to 20% . Table records the recurrence rates of both abdominal and perineal approaches published in the last decade …”

Section: Discussionmentioning

confidence: 99%

“…Perineal approaches include Delorme's repair (DR), perineal rectosigmoidectomy (PR, also known as Altemeier's repair) and Thiersch encirclement procedures. Traditionally, the perineal approach is reserved for the frail and elderly as it can be performed under spinal anaesthesia and its morbidity is reportedly lower . On the other hand, an abdominal approach is considered to have a lower recurrence rate, but it is generally associated with higher morbidity rates.…”

Section: Introductionmentioning

confidence: 99%

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Long‐term outcomes of surgical management of rectal prolapse

Levitt

Makin

et al. 2019

ANZ Journal of Surgery

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Background: Various surgical options for rectal prolapse are available but none have been shown to be clearly superior. The aims of this study were to investigate the long-term recurrence rate of a variety of surgical approaches, their associated morbidities and the types of reoperation used to treat recurrence. Methods: A retrospective analysis was performed of all cases of rectal prolapse surgery within one colorectal surgical unit between January 2000 and June 2017. Abdominal approaches consisted of rectopexy (RP) and resection rectopexy (RRP); perineal approaches included perineal rectosigmoidectomy (PR) and Delorme's repair (DR). Complications were graded according to the Clavien-Dindo classification. The median follow-up was 4.5 years (interquartile range 1.5-10.1, maximum 16.5). Statistical analysis was performed using Kaplan-Meier to determine recurrence rates. Results: A total of 157 patients were included in the study. The numbers for each procedure were: DR (n = 55), RRP (n = 44), RP (n = 38) and PR (n = 20). The majority were females (94%). The perineal group were significantly older than the abdominal group (80 versus 67 years, P = 0.0001). At 5 years, the recurrence rates were 52%, 30%, 5% and 3% for DR, PR, RP and RRP, respectively. Morbidity was highest in PR (20%) followed by RRP (18%), RP (16%) and DR (7%) (n.s.). The overall morbidity rates for perineal group and abdominal group were 10.7% and 17.1%, respectively (n.s.). Conclusion: Abdominal approaches have a significantly lower recurrence rate at 5 years but tend to be associated with higher morbidity.

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Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Long‐term outcomes of surgical management of rectal prolapse

Levitt

Makin

et al. 2019

ANZ Journal of Surgery

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“…Altemeier's procedure may provide better long‐term results compared with Delorme's procedure. However, complete resection of the rectum leads to loss of the rectal reservoir and results in poor functional results .…”

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confidence: 99%

How should we manage complete rectal prolapse in men?

Emile

2019

Colorectal Disease

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“…The ideal surgical management for full‐thickness complete RP is not yet established. Controversy still exists between a perineal versus an abdominal approach . The abdominal approach has better functional results with a lower recurrence rate .…”

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confidence: 99%