Perineal rectosigmoidectomy on treatment of rectal procidentia: analysis of 48 cases

Abstract

Objective: To evaluate results obtained in 48 cases of perineal rectosigmoidectomy in patients with rectal procidentia. Methods: 48 medical records of patients undergoing PRS were analyzed, retrospectively. Results: Before surgery, 44 patients (77.1%) reported complaints of anal mass and rectal bleeding was reported 13 times (22.8%). The period of hospitalization was 3.91 days (2 to 12 days). Women were the majority (85.4%). The mean age was 73.8 years (49 to 101 years). The average time of surgery was 72 minutes (40 to 90 minutes). Mechanical anastomosis was performed in 72.9% and manual in 27.1%. Among the 12 (25%) patients with fecal incontinence, continence was achieved in 2 cases. Postoperative complications occurred in five cases -10.5% (two pneumonia and three anastomotic leakages). Recurrence was verified in four patients (8,3%). There were no deaths related to the procedure. Conclusion: Perineal rectosigmoidectomy is a good surgical option for rectal procidentia, with low morbidity and mortality, low recurrence rate and short hospitalization length.

Perfuração de reto secundária a obstrução em alça fechada após retossigmoidectomia perineal (Cirurgia de Altemeier)

“…Rectal prolapse (RP) is an uncommon pathology that can affect any age group, however, its presentation is more common in the elderly, with a higher incidence in female patients. The pathophysiology may be linked to anatomical alterations such as diastasis of the muscles levator ani and redundant sigmoid, sphincter pathologies or alterations in the sacral ligaments (MEDEIROS et al, 2012). The diagnosis of RP is made through physical examination, but complementary tests can be used to rule out differential diagnoses, whereas some symptoms can mimic colorectal malignant pathologies.…”