It’s the procedure not the patient: the operative approach is independently associated with an increased risk of complications after rectal prolapse repair

Fleming, Fergal J.; Kim, M. J.; Gunzler, Douglas D.; Messing, Susan; Monson, J. R. T.; Speranza, Jenny R.

doi:10.1111/j.1463-1318.2011.02616.x

Cited by 22 publications

(15 citation statements)

References 12 publications

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“…The choice of approach was generally influenced by a clinical preference for a PP because of age and/or pre-existing conditions [7]. Our data suggest that in our institution the age of the patient and the prolapsed length were major considerations in selecting the operation type, as in other studies [6,11,14].…”

Section: Discussionmentioning

confidence: 61%

“…Complete rectal prolapse has been studied in various subjects, and some studies have compared abdominal and perineal procedures [1,6]. Abdominal procedures (APs) generally offer lower rates of recurrence but are associated with higher morbidity rates than perineal procedures [1,3,7]. These results might help to select suitable operative procedures for patients with complete rectal prolapse.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of abdominal and perineal procedures for complete rectal prolapse: an analysis of 104 patients

et al. 2014

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PurposeSelecting the best surgical approach for treating complete rectal prolapse involves comparing the operative and functional outcomes of the procedures. The aims of this study were to evaluate and compare the operative and functional outcomes of abdominal and perineal surgical procedures for patients with complete rectal prolapse.MethodsA retrospective study of patients with complete rectal prolapse who had operations at a tertiary referral hospital and a university hospital between March 1990 and May 2011 was conducted. Patients were classified according to the type of operation: abdominal procedure (AP) (n = 64) or perineal procedure (PP) (n = 40). The operative outcomes and functional results were assessed.ResultsThe AP group had the younger and more men than the PP group. The AP group had longer operation times than the PP group (165 minutes vs. 70 minutes; P = 0.001) and longer hospital stays (10 days vs. 7 days; P = 0.001), but a lower overall recurrence rate (6.3% vs. 15.0%; P = 0.14). The overall rate of the major complication was similar in the both groups (10.9% vs. 6.8%; P = 0.47). The patients in the AP group complained more frequently of constipation than of incontinence, conversely, in the PP group of incontinence than of constipation.ConclusionThe two approaches for treating complete rectal prolapse did not differ with regard to postoperative morbidity, but the overall recurrence tended to occur frequently among patients in the PP group. Functional results after each surgical approach need to be considered for the selection of procedure.

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Section: Discussionmentioning

confidence: 61%

Section: Introductionmentioning

confidence: 99%

Comparison of abdominal and perineal procedures for complete rectal prolapse: an analysis of 104 patients

et al. 2014

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“…another strength of this study is that the nsQiP dataset itself is well validated, particularly for colorectal procedures, and followed previously used rigorous methods. [11][12][13] accepting the conceptual notion that resident involvement and variables that drive outcome can never be fully described, we attempted to minimize the possibilities of confounding by narrowing analysis to 2 CPt codes for partial colectomy. to account for effect modification by resident experience and operative approach, cases were stratified by postgraduate year and operative approach.…”

Section: Discussionmentioning

confidence: 99%

Outcomes Associated With Resident Involvement in Partial Colectomy

Iannuzzi

Rickles

Deeb

et al. 2013

Diseases of the Colon &Amp; Rectum

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“…However, these procedures tend to be time-consuming, they demand advanced surgical techniques and the recurrence rate is not low. [3,4,5,6,7] Here, we report a simple procedure that repairs rectal prolapse perineally by using non-absorbable mesh for anoplasty. The indications for this procedure is complete rectal prolapse, old age and associated with other comorbidities.…”

Section: Rectal Prolapse Anatomic Abnormalitiesmentioning

confidence: 99%

“…Many procedures are reported to repair rectal prolapse and the procedure used depends on the severity of the prolapse and the status of the patient. [2,3,4,5,6] However, surgical intervention is the mainstream treatment. In elderly and fragile patients, perineal approaches are preferred; for example, Delorme's procedure with or without the Thiersch procedure and the Gant-Miwa procedure are options for mild rectal prolapse, whereas Altemeier's procedure is the treatment of choice for severe rectal prolapse.…”

Section: Introductionmentioning

confidence: 99%

Mesh Anoplasty- An Unique Approach to Rectal Prolapse

Renganathan¹,

Jayakumar²,

Venkadesan³

et al. 2017

jemds

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BACKGROUNDRectal prolapses are not life-threatening; however, the bleeding and faecal incontinence associated with them significantly erode quality of life and can cause concern among patients, caregivers in nursing homes. Many procedures have been reported that repair of rectal prolapses and the procedure used depends on the severity of the prolapsed [1] ; however, the treatments are yet to be established. Here, we report a simple and safe procedure to repair rectal prolapse perineally using non-absorbable polypropylene mesh for anoplasty. We performed this procedure on 10 patients. All patients were followed up for over 3 years and none had any recurrences of their rectal prolapses. No complications occurred during the operations and postoperative periods. Most patients who have prolapses are elderly and fragile, so the treatment must be easy, safe and rapid. While rectal prolapse is not life-threatening, the goal of treatment is to alleviate its symptoms. The procedure we describe is consistent with this concept. We suggest that this procedure, which uses non-absorbable polypropylene mesh, might be a better option for the treatment of complete rectal prolapse. We will continue to surgically correct complete rectal prolapses and investigate the long-term outcomes of the procedure.

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It’s the procedure not the patient: the operative approach is independently associated with an increased risk of complications after rectal prolapse repair

Abstract: A perineal approach is safer than an abdominal approach to the treatment of rectal prolapse. Regarding an abdominal operation, rectopexy has fewer major complications than resection.

Cited by 22 publications

References 12 publications

Comparison of abdominal and perineal procedures for complete rectal prolapse: an analysis of 104 patients

Comparison of abdominal and perineal procedures for complete rectal prolapse: an analysis of 104 patients

Outcomes Associated With Resident Involvement in Partial Colectomy

Mesh Anoplasty- An Unique Approach to Rectal Prolapse

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