Ivalon (polyvinyl alcohol) sponge in the repair of complete rectal prolapse

Morgan, C. Naunton; Porter, N. H.; Klugman, David

doi:10.1002/bjs.1800591102

Cited by 96 publications

(26 citation statements)

References 6 publications

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“…4,5,31,36,44,45,[47][48][49] Polyvinyl alcohol sponge placement carries an increased risk of infectious complications. 47,48 In 1996, Athanasiadis et al 45 performed posterior mesh rectopexy in 222 patients, with sigmoidectomy in 145.…”

Section: Prosthetic or Mesh Rectopexymentioning

confidence: 99%

Surgical Management of Rectal Prolapse

Madiba

Baig²,

Wexner³

2005

Arch Surg

304

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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Section: Prosthetic or Mesh Rectopexymentioning

confidence: 99%

Surgical Management of Rectal Prolapse

Madiba

Baig²,

Wexner³

2005

Arch Surg

304

228

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“…Dabei findet sich in der Literatur eine beträchtliche Quote von zwischen 2,6-16% Patienten, die einen Beckenbodenabszess postoperativ entwickelten [76,79] mit der Konsequenz der notwendigen Entfernung des Schwammes. Theoretisch schien die nur teilweise Umschlingung des Rektums die Rate der postoperativen Obstipation deutlich zu verringern.…”

Section: Operation Nach Wellsunclassified

“…Fasst man die Ergebnisse der WellsOperation für die Rezidiventwicklung aus größeren Studien zusammen [76,80], liegt sie bei ca. 3% und damit im vergleichbaren Rahmen der Operation nach Ripstein.…”

Section: Operation Nach Wellsunclassified

“…Mit den Überlegungen, dass nach Pexie des Rektums eine deutliche Entlastung des Beckenbodens zustandekommt und damit eine Regeneration der Nerven mög-lich wäre, wurden die Verbesserung der Kontinenzleistung erklärt. Dabei wird für die pexierenden Verfahren eine entsprechende Verbesserung 6-12 Monate postoperativ zwischen 46 und 64% beschrieben [76,83,84,85].…”

Section: Operation Nach Wellsunclassified

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Rectal prolapse in adults

Heitland

2004

Chirurg

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The etiology of rectal prolapse is unclear. Diagnosis is easy by local inspection. The ideal surgery would repair the prolapse, correct any functional problems such as incontinence or constipation, be minimally invasive and cost-effective, and result in minimal morbidity and recurrence. The best surgical repair remains controversial-whether by the transanal/perineal or abdominal approach-with or without resection and rectopexy. There are no prospective-randomized studies that convincingly answer the numerous questions. The best possible option today seems to be the abdominal/laparoscopic method with a resection rectopexy according to Frykman and Goldberg.

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“…1). Constipation has been reported to be the predominant symp tom in 19-65% of patients [26][27][28], Fecal incontinence is also commonly associated with rectal prolapse [29] and is a common long-term complication. This may be due to a combination of repeated traction on the pu dendal nerves, abnormal perineal descent and progressive anal dilatation [16,22,30], Pro gressive anal dilatation is thought to lead to low resting [31] and squeeze pressures [32,33].…”

Section: Complete Rectal Prolapsementioning

confidence: 99%

Current Advances and Controversies in the Surgical Therapy for Anorectal Motility Disorders

Nyam

Pembérton²

1997

Dig Dis

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It is the goal of this review to discuss the increasingly common problem of anorectal motility disorders and their potential surgical management. Perhaps the most important goal in patients with anorectal motility disorders is to categorize them accurately into etiologic groups. The reason is that approaches to medical and surgical therapy are highly dependent on accurate categorization of these patients with motility disorders. This review is written from the perspective of a surgical practice which sees a high volume of patients with anorectal motility disorders and has a very logical, nearly algorithmic approach to the evaluation and management of these patients. The review is not exhaustive, nor does it include all possible alternatives. It is meant to be a relatively practical guide to physicians and surgeons who deal with patients with anorectal motility disorders and is based on the experience of surgeons and gastroenterologists who see large numbers of these patients.

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Ivalon (polyvinyl alcohol) sponge in the repair of complete rectal prolapse

Cited by 96 publications

References 6 publications

Surgical Management of Rectal Prolapse

Surgical Management of Rectal Prolapse

Rectal prolapse in adults

Current Advances and Controversies in the Surgical Therapy for Anorectal Motility Disorders

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