Outcomes of stapler repair with anastomosis for stoma prolapse

Evaluation of the Outcome of Local Surgery for Stomal Prolapse

“…SR, however, has the disadvantage of a high cost, owing to the use of several stapler cartridges. According to a report by Koide et al, [13] the mean number of stapler cartridges used was 4.6 (range: 3 to 8); the median number in this study was 4 (range: 2 to 9). There have been reports on ways of reducing medical costs as much as possible, which involve making holes in the prolapsed intestine at two loci, one at the level of intestinal separation, 1 to 2 cm above the skin, and another passing one fork of the stapler device through those areas to separate the intestine [7,11].…”

“…Several local surgical techniques for treating stomal prolapse have been reported previously [3][4][5][6][7][8][9][10][11][12][13][14][15][16], but most reports have been case series with no more than 10 patients. The largest number of patients in a previous report was 25, with surgery performed by Koide et al using staplers [13]; only one patient suffered recurrent stomal prolapse within a year after surgery.…”

“…Several local surgical techniques for treating stomal prolapse have been reported previously [3][4][5][6][7][8][9][10][11][12][13][14][15][16], but most reports have been case series with no more than 10 patients. The largest number of patients in a previous report was 25, with surgery performed by Koide et al using staplers [13]; only one patient suffered recurrent stomal prolapse within a year after surgery. However, in an investigation of 16 patients who underwent Altemeier's procedure, another extraperitoneal local surgical procedure was performed by Mittel et al [5]; the postoperative stomal prolapse recurrence rate was high (43.6%), with most cases occurring within 1 year.…”

“…SR was performed according to a previously reported technique [6,9,13]. After anesthesia was administered, the surplus intestine was pulled out as far as possible and allowed to prolapse.…”

“…There have been several reports of such local surgical methods, but no large-scale studies have been performed previously, and the outcome of local surgery for stomal prolapses is 2 of 7 unclear. In terms of the principal surgical methods, a few case series have been reported involving the application of Altemeier's procedure for rectal prolapse [3][4][5] and methods using staplers [6][7][8][9][10][11][12][13][14]. In both methods, the intestine that has prolapsed through the stoma is excised at a level external to the abdominal wall; the stoma is then reconstructed.…”