Transsacral Rectopexy for Recurrent Complete Rectal Prolapse

Araki, Yasumi; Isomoto, Hiroharu; Tsuzi, Yoshiaki; Matsumoto, Atsushi; Yasunaga, Masafumi; Yamauchi, Kenzi; Hayashi, Katsumi; Kodama, Takahito

doi:10.1007/s005950050552

Cited by 3 publications

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“…The effect of surgical treatment on anal sphincter function in patients with rectal prolapse patients. This figure is similar to those found in the literature (8,9,10). The surgical treatment had significant influence on anal function.…”

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confidence: 91%

The Effect of Surgical Treatment on Anal Sphincter Function in Patients with Rectal Prolapse

Kościński¹,

Stadnik²

2008

Polish Journal of Surgery

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The aim of the study was analysis of an anal sphincter function in patients before and after surgery for rectal prolapse. Material and methods. Between 1987 and 2005, 49 patients underwent operations for rectal prolapse. The anal sphincter function was analyzed in 17 of these patients. Abdominal approach surgery was performed in 13 patients; this involved rectopexy in 11 and sigmorectal resection in two others. A transanal approach was chosen in four patients, with the Mikulicz technique in two cases, the Delorme procedure in one, and the Altmeier procedure in the remaining case. Results. In all patients who were operated using the transanal approach, we observed some regression in anal sphincter insufficiency. Among the patients operated using the abdominal approach, first degree incontinence persisted in three cases, second degree in five cases, and third degree persisted in four cases. As a result of the surgical treatment of rectal prolapse by rectopexy and transanal approach, we observed a statistically significant increase in the resting anal sphincter pressure; this increase on average reached 58.8 mm Hg. A statistically significant increase in the average maximum squeeze anal sphincter pressure (95.9 mm Hg) was attained after the surgical procedures were performed on patients with rectal prolapse. Conclusion. The results suggest that the improvement of anal function in the control of stool and flatus after surgical treatment for rectal prolapse appears to be the result of an increase in the rest and maximal squeeze pressures of the anal sphincters.

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confidence: 91%

The Effect of Surgical Treatment on Anal Sphincter Function in Patients with Rectal Prolapse

Kościński¹,

Stadnik²

2008

Polish Journal of Surgery

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“…The postoperative follow‐up period for patients undergoing an abdominal approach ranged from < 1 year to 23 years, but the median follow‐up could not be calculated as some studies did not provide exact data. There were no recurrences in four studies . A recurrence rate of 5.6% was reported after abdominal rectopexy among 257 patients including primary ( n = 196) and recurrent ( n = 61) rectal prolapse .…”

Section: Resultsmentioning

confidence: 88%

“…Eight studies including 135 patients treated by abdominal rectopexy of any kind for recurrent rectal prolapse were identified , only one of which reported use of a laparoscopic approach . A further four studies involving 23 patients who underwent resection rectopexy were included in this review , in addition to three patients who underwent anterior resection in a study by Hool et al .…”

Section: Resultsmentioning

confidence: 99%

“…Preoperative continence was assessed with established continence scores in two studies , with three conducting anorectal physiology in addition . Araki et al .…”

Section: Resultsmentioning

confidence: 99%

“…Araki et al . used the Pescatori score, anorectal manometry and defaecating proctography in the preoperative evaluation of five patients. Incontinence scores, maximal resting pressures, number of patients with constipation, straining anorectal angle and perineal descent improved postoperatively.…”

Section: Resultsmentioning

confidence: 99%

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A systematic review of the literature on the surgical management of recurrent rectal prolapse

et al. 2015

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Surgical Management of Rectal Prolapse

Madiba

Baig²,

Wexner³

2005

Arch Surg

301

228

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Background:The problem of complete rectal prolapse is formidable, with no clear predominant treatment of choice. Surgical management is aimed at restoring physiology by correcting the prolapse and improving continence and constipation with acceptable mortality and recurrence rates. Abdominal procedures are ideal for young fit patients, whereas perineal procedures are reserved for older frail patients with significant comorbidity. Laparoscopic procedures with their advantages of early recovery, less pain, and possibly lower morbidity are recently added options. Regardless of the therapy chosen, matching the surgical selection to the patient is essential.Objective: To review the present status of the surgical treatment of rectal prolapse.Data Sources: Literature review using MEDLINE. All articles reporting on rectopexy were included.Study Selection: Articles reporting on prospective and retrospective comparisons were included. Case reports were excluded, as were studies comparing data with historical controls. Data Extraction:The results were tabulated to show outcomes of different studies and were compared. Studies that did not report some of the outcomes were noted as "not stated."Data Synthesis: Abdominal operations offer not only lower recurrence but also greater chance for functional improvements. Suture and mesh rectopexy produce equivalent results. However, the polyvinyl alcohol (Ivalon) sponge rectopexy is associated with an increased risk of infectious complications and has largely been abandoned. The advantage of adding a resection to the rectopexy seems to be related to less constipation. Laparoscopic rectopexy has similar results to open rectopexy but has all of the advantages related to laparoscopy. Perineal procedures are better suited to frail elderly patients with extensive comorbidity.Conclusions: Abdominal procedures are generally better for young fit patients; the results of all abdominal procedures are comparable. Suture and mesh rectopexy are still popular with many surgeons-the choice depends on the surgeon's experience and preference. Similarly, the procedure may be done through a laparoscope or by laparotomy. Perineal procedures are preferable for patients who are not fit for abdominal procedures, such as elderly frail patients with significant comorbidities. The decision between perineal rectosigmoidectomy and Delorme procedures will depend on the surgeon's preference, although the perineal rectosigmoidectomy has better outcomes.

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Transsacral Rectopexy for Recurrent Complete Rectal Prolapse

Cited by 3 publications

References 0 publications

The Effect of Surgical Treatment on Anal Sphincter Function in Patients with Rectal Prolapse

The Effect of Surgical Treatment on Anal Sphincter Function in Patients with Rectal Prolapse

A systematic review of the literature on the surgical management of recurrent rectal prolapse

Surgical Management of Rectal Prolapse

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