Perineal Approach in Rectal Prolapse: Case Report

Year 2015, Volume: 40 Issue: 2, 390 - 395, 29.09.2015

Tevfik Eker Yusuf Sevim , Akın Kocaay Mehmet Seven Toygar Sarı Cihangir Akyol

https://doi.org/10.17826/cutf.58156

Abstract

Rectal prolapse is a condition where the full thickness rectal wall or mucosa of the rectum protrudes from the anus. The surgical treatment of rectal prolapse is performed either abdominally or perineally . The perineal procedures are prefered with old patients with the high risk for surgery, and rectosigmoidectomy named as Altemeier procedure is the most preffered procedure. Here in we present a 79 years-old female patient, admitted to our clinic with the history of 24 hours incarcerated rectal prolapse and 2 cm sized polip. Altemeier procedure was performed under regional anesthesia, the patient was discharged on the 4th postoperative day without any complications. Altemeier procedure can be safely administered in indicated elderly patients by experienced surgeon with low morbidity and mortality rates.

Keywords

Rectal prolapsus, Altemeier procedure

Rektal Prolapsusta Perineal Yaklaşım: Olgu Sunumu

Abstract

Rektal prolapsus anal orifisten protrüde olmuş mukozal ya da tam kat rektal dokunun varlığını ifade eder. Rektal prolapsus tedavisi abdominal veya perineal cerrahilerdir. Yaşlı ve cerrahi açıdan yüksek riskli hastalarda perineal yöntemler tercih edilir ve daha sık olarak Altemeier prosedürü olarak adlandırılan rektosigmoidektomi uygulanır. Kliniğimize inkarsere rektal prolapsus ile başvuran ve Altemeier prosedürü uygulanmış 79 yaşında kadın hasta sunulmaktadır. Başvuruda son 24 saatten itibaren redükte olmamış rektal prolapsus ve 2 cm’lik polip izlediğimiz hastaya rejyonel anestezi altında Altemeier prosedürü uygulandı. Hastada, cerrahi sonrası dönemde komplikasyonu gelişmedi ve postoperatif 4. gün taburcu edildi. Altemeier prosedürü endike olduğu komorbiditesi fazla yaşlı hastalarda, düşük morbidite ve mortalite oranları ile tecrübeli hekimler tarafından güvenle uygulanabilir.

Keywords

Rektal prolapsus, Altemeier prosedürü

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