Comparison of Three Perineal Procedures for the Treatment of Rectal Prolapse

Agachan, Feran; Reissman, Petachia; Pfeifer, Johann; Weiss, Eric G.; Nogueras, Juan J.; Wexner, Steven D.

doi:10.1097/00007611-199709000-00013

Cited by 103 publications

(90 citation statements)

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“…In our series, all cases were electively operated on, and we used the Altemeier procedure in the majority of our recurrences with good results. The mortality rate after the elective procedure ranges from 0 to 5 % [10,21,25]. In our study, no mortality was reported in the Altemeier group.…”

Section: Discussionmentioning

confidence: 45%

“…The female patient suffered from chronic ischaemic heart disease prior to surgery. After the Delorme procedure, the recurrence rate ranges from 4 to 38 % [19][20][21]. However, Agachan et al [21] reported high recurrence rate that accounted to 38 %, but the group of the studied patients in the paper was very small (8 patients); thus, the real rate seems to be from 4 to 26 % [22].…”

Section: Discussionmentioning

confidence: 85%

“…Adding the levatoroplasty to the Altemeier procedure leads to improvement of continence, and also it improves the shortterm recurrence rate compared with the perineal rectosigmoidectomy alone [21]. Of all the perineal procedures, the perineal rectosigmoidectomy with levatoroplasty has been connected with the longest recurrence-free interval, the lowest overall recurrence rate, and the best effects in relation to bowel function-continence as well as constipation [8,10].…”

Section: Discussionmentioning

confidence: 99%

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Rectal Prolapse in Women—Outcomes of Perineal and Abdominal Approaches

et al. 2014

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The aim of the study was to assess the clinical and functional results of surgical treatment of female patients with rectal prolapse. In the period of 2003-2010, the group of 86 female patients (mean age of 67±10) underwent surgery due to rectal prolapse. The group of 24 patients (27.9 %) suffered from mild anal incontinence. They were operated on with open sutured rectopexy (18 pts), Altemeier (45 pts) and Delorme procedure (23 pts). Prior to surgery and after operation, clinical and function results were obtained. The follow-up period amounted to 32±11 months. In perineal approaches, we found mortality in one patient (1.4 %, Delorme) and anastomotic leak in four patients (5.9 %). The recurrence rate in the perineal group was 11.8 % (eight patients). We noted one recurrence in the rectopexy group (5.6 %). The Altemeier procedure revealed the most significant impact on the function of the anal sphincter muscles and resting pressures (42±7 vs 53±9 cm H 2 O; p=0.0082). If anterior levatoroplasty was added, the benefits referred also to squeeze pressures (41±8 vs 58±9 cm H 2 O; p=0.006 and 42±10 vs 56±9 cm H 2 O; p= 0.01). In the treatment of rectal prolapse, there is still no consensus about the operation of choice. Selection of the appropriate method should be based on clinical findings and patients' comorbidities to obtain maximal benefits and minimize the postoperative risk and failures.

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Section: Discussionmentioning

confidence: 45%

Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

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Rectal Prolapse in Women—Outcomes of Perineal and Abdominal Approaches

et al. 2014

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“…They concluded that Delorme's procedure combined with sphincteroplasty seemed indicated when both clinical and physiological findings showed a concomitant severe pelvic floor dysfunction. However, many other series without sphincteroplasty have shown improvement in continence [9,[12][13][14].…”

Section: Discussionmentioning

confidence: 99%

Delorme’s Procedure for Full-Thickness Rectal Prolapse; Does it Alter Anorectal Function

et al. 2012

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Clinical and anorectal manometric results of Delorme's procedure for full-thickness rectal prolapse were assessed retrospectively. Thirty-seven patients with full-thickness rectal prolapse who were operated on with Delorme's procedure were included in the study. They were 11 males and 26 females with mean age of 54± 4.4 years (range 15-70 years) and mean follow-up period of 27 ± 4.6 months (15-48 months). The mean operative time was 65 ± 4.5 min (60-90 min); there was no mortality and blood loss was minimal. Mean hospital stay was 3.5 days (2-6 days). Outcomes of the procedure were satisfactory in 29 patients (78.4%). Dissatisfaction came from recurrence and persistence of fecal incontinence. Prolapse recurrence had been observed in six patients; three of them were treated by the same technique and showed no recurrence, and the others were treated by either mucosal resection (1) or abdominal resection rectopexy (2). Constipated patients showed improved symptoms in 7 of 10 cases. Of 11 patients who were incontinent preoperatively, seven patients became fully continent. Postoperatively, anorectal manometric studies (MRP, MSP, MTV, and UDV) showed significant improvement in all patients with intact RAIR. Delorme's operation, coupled with avoidance of abdominal procedures, is the treatment of choice of rectal prolapse in elderly frail patients and in patients with defecatory disorders.

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“…The reported mortality rates are from 0 to 5% and recurrence rates of 0-16%. Studies in which levatorplasty (levatorplasty) and other studies that were not performed are included in this data [7,8,14,[27][28][29][30][31][32][33]. The levatorplasty decreases the rate of recurrence when associated with perineal rectosigmoidectomy [3,4].…”

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confidence: 99%