Procidentia: Definitive corrective surgery

Ripstein, Charles B.

doi:10.1007/bf02587406

Cited by 47 publications

(14 citation statements)

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“…Die abdominale Rektopexie wurde erstmals von Kfimmel beschrieben, mit zunfichst hohen Rezidivraten; niedrigere Rezidiv-und Komplikationsraten wurden nach der Einffihrung verschiedener Fixationsgrundlagen berichtet, zur Anwendung kommen vornehmlich die Operation nach Wells und Ripstein oder deren Variationen [26,41,48]. Die intraabdominale Verwendung nicht resorbierbarer Kunststoffe, nahe bakteriell kontaminierter Organe, ist stets Kritikpunkt dieser Rektopexiemethoden gewesen.…”

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Klinische und funktionelle Ergebnisse der abdominalen Rektopexie unter Verwendung verschiedener Fixierungsgrundlagen

Winde

Reers

Holzgreve

et al. 1993

Langenbecks Arch Chir

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We report our results with abdominal rectopexy (modified Ripstein procedure, Ripstein/Corman) without resection of the colon in 63 patients using lyophylized dura-strips, Vicryl gauze or Dexon gauze, as the underlying fixation material for the mobilized rectum, presacral fascia and fixation suture material. Forty-five of 64 patients (71.4%) were reevaluated by proctoscopic examination and questioning; the mean follow-up time was 52.5 months (range 3-136 months). Postoperative mortality due to the method was 0%; the mortality was 1.6% (n = 1/63) in general for the first postoperative 30-day period as a result of cardiac complications. There were three complications (4.7%) the durating operation. Postoperative morbidity was 25.4% (16/63); infectious complications occurred in 12.7% (8/63) of cases, with one case of spontaneous closure of a pelvicutaneous fistula after intraoperative injury to the rectal wall. Full-thickness rectal prolapse appeared after rectopexy in 4.4% (2/45) (dura material alone) and mucosal prolapse was seen in 15.5% (7/45) of the follow-up group. Constipation was reduced by 28.6% (18/63) to 22.2% during the follow-up. Seventeen of 28 patients (60.7%) with incontinence showed an improvement; total continence was registered in 35.7% (10/28). The increase in continence as a result of abdominal rectopexy was significant (Wilcoxon, P = 0.05). The special aspects of being in an older age group, having a long history of procidentia, the number of deliveries, the length of the preoperative incontinence period all showed no influence on the postoperative degree of continence (Spearman's rank correlation). In 7/15 cases with persisting incontinence after rectopexy, postanal repair (Parks) was efficient in 7/7 cases leading to total or partial continence.(ABSTRACT TRUNCATED AT 250 WORDS)

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Klinische und funktionelle Ergebnisse der abdominalen Rektopexie unter Verwendung verschiedener Fixierungsgrundlagen

Winde

Reers

Holzgreve

et al. 1993

Langenbecks Arch Chir

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“…As técnicas por via abdominal, como a retopexia abdominal, têm sido a mais preferida em nosso meio, devido à menor taxa de recidiva. A retopexia pode ser realizada d e várias formas desde simples sutura, a clássica promonto-sacro-fixação, até o emprego de próteses como a tela de polipropileno, esponja álcool-polivinil ou outros materiais 2,4,7,8,13 . Recentemente, as retopexias têm sido realizadas por meio de videolaparoscopia [10][11][12][13] , e apresentam algumas vantagens, tais como menor agressão cirúrgica, menor tempo de internação e melhor resultado estético.…”

Section: Discussionunclassified

“…Apesar de ser uma afecção conhecida há vários séculos, ainda existem controvérsias sobre o tratamento. O fato é demonstrado pelas várias opções terapêuticas existentes [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] . A escolha do procedimento mais adequado continua sendo um problema para o cirurgião, que acaba utilizando a técnica mais familiar, porém não a melhor para as condições do paciente.…”

Section: Introductionunclassified

Resultados de tratamento do prolapso retal pela técnica de delorme e de retopexia

Fang¹,

Candelária²,

Klug³

et al. 2008

Rev. Assoc. Med. Bras.

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“…The use of laxatives is deeply rooted in medical and social traditions (Ripstein 1972), and vast amounts are consumed in the western world (Tedesco & Di Piro 1985), especially by elderly persons (Bannister et al 1987;Whitehead et al 1989). Unfortunately, many elderly persons use them inappropriately (Tedesco & Di Piro 1985).…”

Section: Laxativesmentioning

confidence: 99%

“…Surgical approaches to rectal intussusceptions and prolapse consist of various resuspension procedures such as the Ripstein procedure, the Thiersch operation, the Ivalon sponge wrap, and abdominal rectopexy with sigmoid resection (Poisson & Devroede 1983;Ripstein 1972;Wells 1959). As with rectocoeles, intussusceptions are not uncommon in nonconstipated individuals and their presence in constipated patients should not imply causation.…”

Section: Drugs and Aging 3 (3) 1993mentioning

confidence: 99%

Constipation in Elderly Patients

Wald

1993

Drugs & Aging

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The incidence of constipation appears to increase with increasing age, particularly after the age of 65. There are few data on the age-related physiological changes of colonic and anorectal function; however, anal sphincter pressures are decreased in elderly patients, while colonic transit time does not appear to be altered. The successful management of constipation in elderly patients requires an understanding of colorectal function, careful characterisation of the patient's complaint, and in selected patients, specialised studies of colonic and anorectal function. The cause of constipation in elderly patients is often multifactorial and may include inactivity, inappropriate diet, depression and confusion, certain medications, and neuromuscular disorders. The treatment of chronic constipation should be based on the nature of the complaint and the presumed pathophysiological mechanisms at work in each patient. Treatment will be based on one or more strategies including dietary changes, laxatives, and in carefully defined cases, surgery.

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Procidentia: Definitive corrective surgery

Cited by 47 publications

References 0 publications

Klinische und funktionelle Ergebnisse der abdominalen Rektopexie unter Verwendung verschiedener Fixierungsgrundlagen

Klinische und funktionelle Ergebnisse der abdominalen Rektopexie unter Verwendung verschiedener Fixierungsgrundlagen

Resultados de tratamento do prolapso retal pela técnica de delorme e de retopexia

Constipation in Elderly Patients

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