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Abdominal and perineal approaches in the surgical treatment of rectal prolapse

Year 2012, Volume: 39 Issue: 1, 83 - 88, 01.03.2012
https://doi.org/10.5798/diclemedj.0921.2012.01.0100

Abstract

Introduction: Rectal prolapse is a disease, which is an important cause of social and functional problems and has a continuing debate about the ideal surgical treatment of itself. In this study, we aimed to investigate the abdominal and perineal approaches with early and late postoperative result in the patients undergoing surgery for rectal prolapse. Materials and methods: Between 2006-2011, the records of 21 patients undergoing surgery with the diagnosis of rectal prolapse were reviewed, retrospectively. The demographic and physical examination findings, surgical proce-dures, early and late postoperative complications, recurrence and mortality rates were recorded. Results: The median age was 43 years and female/male ratio was 1.63/1. The most common presenting complaint was gas control failure and often wetting with mucus. Stage 1 and stage 3 rectal prolapses was detected in 19% and 81% of the patients, respectively. The most common surgical procedure was Notaras (54%). Early postoperative complications were seen in 14.3% of the patients. There were no postoperative recurrence, mortality and complica-tion requiring re-exploration. Advanced age and shorter duration of hospital stay were determined and often per-formed under regional anesthesia in the patients undergoing perineal approach. No statistical differences were ob-served in terms of early postoperative complications and recurrence. Conclusion: Results of abdominal and perineal approaches were similar, when they were applied with taking into account the risk factors for surgical treatment, findings of the patients and the surgeon's experience.

References

  • Boccasanta P, Venturi M, Barbieri S, Roviaro G. Impact of new technologies on the clinical and functional outcome of Altemeier’s Procedure: A randomized, controlled trial. Dis Colon Rectum 2006; 49(5): 652-60.
  • Karulf RE, Madoff RD, Goldberg SM. Rectal prolapse. Curr Probl Surg 2001; 38(10): 771-832.
  • Riansuwan W, Hull TL, Bast J, Hammel JP, Church JM. Comparison of perineal operations with abdominal opera- tions for full-thickness rectal prolapse. World J Surg 2010; 34(5): 1116–22.
  • Akcan A, Sözüer E, Akyıldız H, et al. Tam kat rektal prolap- sus cerrahi tedavisinde rektopeksi ve rektopeksi ile birlikte sigmoid rezeksiyonun karşılaştırılması. Ulusal Cerrahi Der- gisi 2007; 23(2): 54-7.
  • Michalopoulos A, Papadopoulos VN, Panidis S, et al. Surgi- cal management of rectal prolapse. Tech Coloproctol 2011; 15(1): 25–8.
  • Hoel AT, Skarstein A, Ovrebo KK. Prolapse of the rectum, long-term results of surgical treatment. Int J Colorectal Dis 2009; 24(2): 201–7.
  • Altemeier WA, Culbertson WR, Schowegerdt C, Hunt S. Nineteen years experience with the one stage perineal re- pair of rectal prolapse. Ann Surg 1971; 173(6): 993-1006.
  • Boutsis C, Ellis H. The Ivalon sponge wrap operation for rectal prolapse. Dis Colon Rectum 1974; 17(1): 21-37.
  • Çalıskan C, Korkut AM, Fırat Ö, Akgün E, Osmanoğlu H. Rectal prolapse experience: 68 cases in 27 years. Ege Jour- nal of Medicine 2008; 47(1): 29-34.
  • Frykman HM. Abdominal proctopexy and primary sigmoid resection for rectal procidentia. Am J Surg 1955; 90(5): 780–9.
  • Gordon PH. In: Gordon PH, Nivatvongs S, eds. Principles and Practice of Surgery for the Colon, Rectum, and Anus, 2nd ed. St. Louis, MO: Quality Medical Publishing Inc, 1999: 575–717.
  • Tobin SA, Scott IH. Delorme operation for rectal prolapse. Br J Surg 1994; 81(11): 1681–4.
  • Longo A. Treatment of hemorrhoid disease by reduction of mucosa and hemorrhoidal prolapse with a circular suturing device: a new procedure. In: Proceedings of 6th World Con- gress of Endoscopic Surgery, Rome, Italy, 1998: 777–84.
  • Madiba TE, Baig MK, Wexner SD. Surgical Management of Rectal Prolapse. Arch Surg 2005; 140(1): 63-73
  • Welton ML. Anorectum. In: Way LW, Doherty GM, eds. Current Surgical Diagnosis and Treatment, 11th ed. New York: McGraw-Hill, 2003; 32: 764-6.
  • Özkan S, Özkan FC, Sönmez H, Ergenoglu O, Kekeç Y. Rektal prolapsus tamiri ve fonksiyonel sonuçları. Çagdaş Cerrahi Dergisi 2000; 14: 170-74.
  • Corman ML, Aliıson SI, Kuehne JP. Rectal Prolapse. Soli- tary Rectal Ulcer, Syndrome of the Descending Penneum and Rectocele. Handbook of Colon and Rectal Surgery 4th ed. Philadelphia, Lippincott Williams & Wilkins 2002; 17: 246-77.
  • Akgün YA, Demirel AH, Kapan M, Öktem Ö, Öngören AU, Tezel S. Rektal prolapsusun tedavisinde rektopeksinin yeri. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi 2004; 37(1): 37-41.
  • Steele SR, Goetz LH, Minami S, Madoff RD, Mellgren AF, Parker SC. Management of recurrent rectal prolapse: surgi- cal approach influences outcome. Dis Colon Rectum 2006; 49(4): 440–5.
  • Mellgren A, Dolk A, Johanscon C. Enterocele is correct- able using the Ripstein rectopexy. Dis Colon Rectum 1994; 37(8): 800-4.
  • Sayfan J, Pinho M, Williams AJ, Keighley MRB. Sutured posterior abdominal rectopexy with sigmoidectomy com- pared with Marlex rectopexy rectal prolapse. Br J Surg 1990; 77(2): 143-5.
  • Sen D. Rectal prolapse. In: Alemdaroglu K, Akcal T, Bugra D, eds. Kolon Rektum ve Anal Bölge Hastalıkları. Istanbul: Ajans Plaza, 2004: 259–73.
  • Agachan F, Reissman P, Pfeifer J, Weiss EG, Nogueras JJ, Wexner SD. Comparison of three perineal procedures for the treatment of rectal prolapse. South Med J 1997; 90(9): 925-32.
  • Benoist S, Toffinder N, Gould S, Chang A, Darzi A. Func- tional results two years after laparoscopic rectopexy. Am J Surg 2001; 182(2): 168-73.
  • Kim DS, Tsang CB, Wong WD, Lowry AC, Goldberg SM, Madoff RD. Complete rectal prolapse: evolution of man- agement and results. Dis Colon Rectum 1999; 42(4): 460-9.
  • Cuthbertson AM, Smith JA. An abdominal repair for com- plete rectal prolapse. ANZ J Surg 1988; 58(6): 499-503

Abdominal and perineal approaches in the surgical treatment of rectal prolapse

Year 2012, Volume: 39 Issue: 1, 83 - 88, 01.03.2012
https://doi.org/10.5798/diclemedj.0921.2012.01.0100

Abstract

Giriş: Rektal prolapsus, sosyal ve fonksiyonel problemlere neden olan ve ideal cerrahi yöntem konusunda tartışmala-rın devam ettiği bir hastalıktır. Bu çalışmada rektal prolapsus nedeniyle cerrahi tedavi uygulanan hastalarımızda ab-dominal ve perineal yaklaşımların postoperatif erken ve geç dönem sonuçlarla beraber araştırılması amaçlandı. Gereç ve yöntem: 2006-2011 yılları arasında rektal prolapsus tanısıyla cerrahi tedavi uygulanan 21 hastanın kayıtla-rı retrospektif olarak değerlendirildi. Hastalara ait demografik ve fizik muayene bulguları, uygulanan cerrahi yöntem-ler, postoperatif erken ve geç dönemde gelişen komplikasyonlar, nüks ve mortalite oranları kaydedildi. Bulgular: Hastaların medyan yaş 43 olup, kadın/erkek oranı 1.63/1 idi. En sık başvuru şikayeti gaz kontrolünde bo-zukluk ve sıklıkla mukusla ıslanma idi. Fizik muayenede hastaların %19\'unda evre 1 ve %81\'inde evre 3 rektal pro-lapsus saptandı. En sık uygulanan cerrahi yöntem Notaras\'tı (%52.4). Hastaların % 14.3\'ünde postoperatif erken dö-nemde komplikasyon gelişti. Postoperatif mortalite, nüks ve reeksplorasyon gerektiren bir komplikasyon gözlenmedi. Perineal yaklaşım uygulanan hastalarda yaş daha ileri ve hastanede yatış süresi daha kısaydı ve sıklıkla rejyonel anestezi altında uygulandı. Postoperatif erken komplikasyonlar ve nüks gelişimi açısından istatistiksel farklılık izlen-medi. Sonuç: Cerrahi tedavi açısından risk faktörleri, hastaya ait bulgular ve cerrahın tecrübesi göz önünde bulundurularak uygulanacak abdominal veya perineal yaklaşımlara ait sonuçlar benzerdir.

References

  • Boccasanta P, Venturi M, Barbieri S, Roviaro G. Impact of new technologies on the clinical and functional outcome of Altemeier’s Procedure: A randomized, controlled trial. Dis Colon Rectum 2006; 49(5): 652-60.
  • Karulf RE, Madoff RD, Goldberg SM. Rectal prolapse. Curr Probl Surg 2001; 38(10): 771-832.
  • Riansuwan W, Hull TL, Bast J, Hammel JP, Church JM. Comparison of perineal operations with abdominal opera- tions for full-thickness rectal prolapse. World J Surg 2010; 34(5): 1116–22.
  • Akcan A, Sözüer E, Akyıldız H, et al. Tam kat rektal prolap- sus cerrahi tedavisinde rektopeksi ve rektopeksi ile birlikte sigmoid rezeksiyonun karşılaştırılması. Ulusal Cerrahi Der- gisi 2007; 23(2): 54-7.
  • Michalopoulos A, Papadopoulos VN, Panidis S, et al. Surgi- cal management of rectal prolapse. Tech Coloproctol 2011; 15(1): 25–8.
  • Hoel AT, Skarstein A, Ovrebo KK. Prolapse of the rectum, long-term results of surgical treatment. Int J Colorectal Dis 2009; 24(2): 201–7.
  • Altemeier WA, Culbertson WR, Schowegerdt C, Hunt S. Nineteen years experience with the one stage perineal re- pair of rectal prolapse. Ann Surg 1971; 173(6): 993-1006.
  • Boutsis C, Ellis H. The Ivalon sponge wrap operation for rectal prolapse. Dis Colon Rectum 1974; 17(1): 21-37.
  • Çalıskan C, Korkut AM, Fırat Ö, Akgün E, Osmanoğlu H. Rectal prolapse experience: 68 cases in 27 years. Ege Jour- nal of Medicine 2008; 47(1): 29-34.
  • Frykman HM. Abdominal proctopexy and primary sigmoid resection for rectal procidentia. Am J Surg 1955; 90(5): 780–9.
  • Gordon PH. In: Gordon PH, Nivatvongs S, eds. Principles and Practice of Surgery for the Colon, Rectum, and Anus, 2nd ed. St. Louis, MO: Quality Medical Publishing Inc, 1999: 575–717.
  • Tobin SA, Scott IH. Delorme operation for rectal prolapse. Br J Surg 1994; 81(11): 1681–4.
  • Longo A. Treatment of hemorrhoid disease by reduction of mucosa and hemorrhoidal prolapse with a circular suturing device: a new procedure. In: Proceedings of 6th World Con- gress of Endoscopic Surgery, Rome, Italy, 1998: 777–84.
  • Madiba TE, Baig MK, Wexner SD. Surgical Management of Rectal Prolapse. Arch Surg 2005; 140(1): 63-73
  • Welton ML. Anorectum. In: Way LW, Doherty GM, eds. Current Surgical Diagnosis and Treatment, 11th ed. New York: McGraw-Hill, 2003; 32: 764-6.
  • Özkan S, Özkan FC, Sönmez H, Ergenoglu O, Kekeç Y. Rektal prolapsus tamiri ve fonksiyonel sonuçları. Çagdaş Cerrahi Dergisi 2000; 14: 170-74.
  • Corman ML, Aliıson SI, Kuehne JP. Rectal Prolapse. Soli- tary Rectal Ulcer, Syndrome of the Descending Penneum and Rectocele. Handbook of Colon and Rectal Surgery 4th ed. Philadelphia, Lippincott Williams & Wilkins 2002; 17: 246-77.
  • Akgün YA, Demirel AH, Kapan M, Öktem Ö, Öngören AU, Tezel S. Rektal prolapsusun tedavisinde rektopeksinin yeri. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi 2004; 37(1): 37-41.
  • Steele SR, Goetz LH, Minami S, Madoff RD, Mellgren AF, Parker SC. Management of recurrent rectal prolapse: surgi- cal approach influences outcome. Dis Colon Rectum 2006; 49(4): 440–5.
  • Mellgren A, Dolk A, Johanscon C. Enterocele is correct- able using the Ripstein rectopexy. Dis Colon Rectum 1994; 37(8): 800-4.
  • Sayfan J, Pinho M, Williams AJ, Keighley MRB. Sutured posterior abdominal rectopexy with sigmoidectomy com- pared with Marlex rectopexy rectal prolapse. Br J Surg 1990; 77(2): 143-5.
  • Sen D. Rectal prolapse. In: Alemdaroglu K, Akcal T, Bugra D, eds. Kolon Rektum ve Anal Bölge Hastalıkları. Istanbul: Ajans Plaza, 2004: 259–73.
  • Agachan F, Reissman P, Pfeifer J, Weiss EG, Nogueras JJ, Wexner SD. Comparison of three perineal procedures for the treatment of rectal prolapse. South Med J 1997; 90(9): 925-32.
  • Benoist S, Toffinder N, Gould S, Chang A, Darzi A. Func- tional results two years after laparoscopic rectopexy. Am J Surg 2001; 182(2): 168-73.
  • Kim DS, Tsang CB, Wong WD, Lowry AC, Goldberg SM, Madoff RD. Complete rectal prolapse: evolution of man- agement and results. Dis Colon Rectum 1999; 42(4): 460-9.
  • Cuthbertson AM, Smith JA. An abdominal repair for com- plete rectal prolapse. ANZ J Surg 1988; 58(6): 499-503
There are 26 citations in total.

Details

Primary Language Turkish
Journal Section Research Articles
Authors

Murat Kapan This is me

Akın Önder This is me

Serkan Polat This is me

İbrahim Aliosmanoglu This is me

Fatih Taskesen This is me

Publication Date March 1, 2012
Submission Date March 2, 2015
Published in Issue Year 2012 Volume: 39 Issue: 1

Cite

APA Kapan, M., Önder, A., Polat, S., Aliosmanoglu, İ., et al. (2012). Abdominal and perineal approaches in the surgical treatment of rectal prolapse. Dicle Tıp Dergisi, 39(1), 83-88. https://doi.org/10.5798/diclemedj.0921.2012.01.0100
AMA Kapan M, Önder A, Polat S, Aliosmanoglu İ, Taskesen F. Abdominal and perineal approaches in the surgical treatment of rectal prolapse. diclemedj. March 2012;39(1):83-88. doi:10.5798/diclemedj.0921.2012.01.0100
Chicago Kapan, Murat, Akın Önder, Serkan Polat, İbrahim Aliosmanoglu, and Fatih Taskesen. “Abdominal and Perineal Approaches in the Surgical Treatment of Rectal Prolapse”. Dicle Tıp Dergisi 39, no. 1 (March 2012): 83-88. https://doi.org/10.5798/diclemedj.0921.2012.01.0100.
EndNote Kapan M, Önder A, Polat S, Aliosmanoglu İ, Taskesen F (March 1, 2012) Abdominal and perineal approaches in the surgical treatment of rectal prolapse. Dicle Tıp Dergisi 39 1 83–88.
IEEE M. Kapan, A. Önder, S. Polat, İ. Aliosmanoglu, and F. Taskesen, “Abdominal and perineal approaches in the surgical treatment of rectal prolapse”, diclemedj, vol. 39, no. 1, pp. 83–88, 2012, doi: 10.5798/diclemedj.0921.2012.01.0100.
ISNAD Kapan, Murat et al. “Abdominal and Perineal Approaches in the Surgical Treatment of Rectal Prolapse”. Dicle Tıp Dergisi 39/1 (March 2012), 83-88. https://doi.org/10.5798/diclemedj.0921.2012.01.0100.
JAMA Kapan M, Önder A, Polat S, Aliosmanoglu İ, Taskesen F. Abdominal and perineal approaches in the surgical treatment of rectal prolapse. diclemedj. 2012;39:83–88.
MLA Kapan, Murat et al. “Abdominal and Perineal Approaches in the Surgical Treatment of Rectal Prolapse”. Dicle Tıp Dergisi, vol. 39, no. 1, 2012, pp. 83-88, doi:10.5798/diclemedj.0921.2012.01.0100.
Vancouver Kapan M, Önder A, Polat S, Aliosmanoglu İ, Taskesen F. Abdominal and perineal approaches in the surgical treatment of rectal prolapse. diclemedj. 2012;39(1):83-8.