The functional and physical state of the anal sphincter complex in the patients with rectal prolapse in the post-surgery period

Abstract

Purpose: The work was aimed at comparative studying of the functional and physical state of the patients with rectal prolapse after surgical treatment with various surgical techniques and at identifying the most optimal procedure technique.Patients and methods: The authors observed 49 patients (32 women, or 65.3 %) aged 22 — 83 years (the median age of women was 46.1 ± 1.3 years old, of men — 48.7 ± 1.4 years old) with the rectal prolapse of varying severity. The Delorme’s procedure was indicated for 28 patients (57.1 %). Perianal proctosigmoidectomy (the Altemeier’s surgery) was performed in 12 patients (24.5 %). In the young patients, preference was given to the Ripstein’s abdominal surgery (nine patients; 18.4 %). To objectively assess the physical state of the anal sphincter apparatus, traditional sphincterometry was performed using S4402 sphincterometer with a nonperfusing sensor (Pro Medika GmbH, Germany), and the functional state of the sphincter complex was subjectively assessed using the Wexner’s score scale.Results: The best results were obtained after the Delorme’s procedure (p<0.05), while the worse results were obtained in the young patients after the Ripstein’s surgery (p<0.05).Conclusion: The obtained results may be used for assessing the functional and physical state of the anal sphincter complex in the surgical treatment of the patients with the rectal prolapse syndrome, especially in those with ASFs of varying severity.