The Best Operation for Rectal Prolapse

“…5 Other advantages include (1) resection of the abundant rectosigmoid, which avoids torsion or volvulus; (2) achieving a straighter course of the left colon and little mobility from the phrenocolic ligament downward, which acts as yet another fixative device 1,5,[61][62][63] ; and (3) relief of constipation in a selected group of patients. 5 It is well suited to patients with a long redundantsigmoidandalonghistoryofconstipation.…”

Section: Resectionmentioning

confidence: 99%

“…4 Rectal prolapse occurs at the extremes of age. 1,8 In the pediatric population, the condition is usually diagnosed by the age of 3 years, with an equal sex distribution. In the adult population, the peak incidence is after the fifth decade and women are more commonly affected, representing 80% to 90% of patients with rectal prolapse.…”

mentioning

confidence: 99%

“…In the adult population, the peak incidence is after the fifth decade and women are more commonly affected, representing 80% to 90% of patients with rectal prolapse. 1,8 Patients with complete rectal prolapse have markedly impaired rectal adaptation to distention, which may contribute to anal incontinence, and consequently more than half of the patients with rectal prolapse have coexisting inconti-nence. [9][10][11][12][13] Constipation is associated with prolapse in 15% to 65% of patients.…”

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confidence: 99%

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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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“…This disease is defined as dislocation of a rectum outside the anal canal (4,5). This dislocation may concern all walls of large intestine and it is defined then as a full (full-thickness) rectal prolapse.…”

mentioning

confidence: 99%

Satisfaction with Life after Rectal Prolapse Surgery

Winiarski¹,

Jóźwiak²,

Pusty³

et al. 2013

Polish Journal of Surgery

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Assessment of satisfaction with life, as a result of comparing own life situation with the individualised personal standards, is an important element for measuring satisfaction with life of the patients suffering from somatic disorders. Literature provides numerous data on satisfaction with life of different groups of patients suffering from somatic disorders. Little space is devoted to the study of the level of satisfaction of patients with rectal prolapse, which is particularly evident in relation to the Polish patient population. the aim of the study was planned to determine the level of satisfaction with life and its determinants among patients with full-thickness rectal prolapse surgery as well as to assess the improvement of continence after this surgery. material and methods. The study group consisted of 20 patients operated on for full-thickness rectal prolapse in the Department of General and Colorectal Surgery, Medical University in Lódź. SWLS (Satisfaction with Life Scale) Diener et al. in the Polish adaptation by Juczyński was used to assess global life satisfaction. Assessment of the incontinence severity and the postoperative improvement was made with Jorge and Wexner scale. Results. The average level of global life satisfaction among patients with rectal prolapse surgery is 21.05 (SD = 4.68) and it corresponds to the level of satisfaction of the total population. In the study group, there were no statistically significant differences in the level of global satisfaction with life depending on age, disease recurrence and continence improvement after surgery. The continence after rectal prolapse surgery improved significantly (p< 0.05). conclusions. The most common consequences of rectal prolapse include incontinence of varying severity. The studies give grounds for considering that a rectal prolapse surgery is an effective method of treatment, being conducive to continence improvement in the study group. Rectal prolapse involves also numerous psychosocial consequences. Due to the complexity of the problem, it appears advisable to undertake further empirical studies with the object of identifying the factors influencing life satisfaction of patients operated on for rectal prolapse.

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The Best Operation for Rectal Prolapse

Cited by 113 publications

References 39 publications

Laparoscopic Suture Rectopexy: An Effective Treatment for Complete Rectal Prolapse

Laparoscopic Suture Rectopexy: An Effective Treatment for Complete Rectal Prolapse

Surgical Management of Rectal Prolapse

Satisfaction with Life after Rectal Prolapse Surgery

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