Results of Surgical Treatment of Total Rectal Prolapse by Posterior Sutured Rectopexy
Languages of publication
The aim of the study was to evaluate the immediate and delayed results of posterior rectopexy in the treatment of total rectal prolapse, its influence on constipation and fecal incontinence, as well as patient quality of life after the procedure.Material and methods. The study group comprised 70 patients who underwent the above-mentioned procedure at the Department of Proctology, Solec Hospital in Warsaw during the period between 1976 and 2003. The study group consisted of 62 female and 8 male patients, aged between 19 and 88 years (mean age 59.9 years). All patients underwent posterior rectopexy. Thirty (43%) of the surgical patients responded to the questionnaire, including 18 (26%) who presented for the postoperative examination. The following were determined: intraoperative complications, frequency of recurrence, fecal incontinence according to Wexner's scale, constipation, influence of the procedure on sphincter condition, and patients' quality of life.Results. All patients underwent total rectal prolapse surgery. Mortality and severe complications were not observed. Rectal prolapse recurrence was not observed. The percentage of intraoperative complications amounted to 4%, and that of postoperative complications 9%. Fecal continence improvement after the operation was confirmed on the basis of Wexner's scale. After surgery the percentage of patients with constipation slightly increased (80% vs 87%).Conclusions. Posterior rectopexy enables the treatment of total rectal prolapse, and is considered to be the most simple, effective and safe operative method, with a low rate of complications and recurrence in patients who qualify for laparotomy. Surgery significantly improves the patients' quality of life.
1 - 11 - 2007
11 - 2 - 2008
- Goligher JC: Surgery of the Anus, Rectum and Colon. Bailliere Tindal, London, 5-th edn. 1984; 246-84.
- Gordon PhH: Principles and Practice of Surgery for the Colon Rectum and Anus. St. Louis Missouri. Rectal Procidentia 1992; 449-81.
- Keighley MRB, Williams NS: Surgery of the anus, rectum and colon. Saunders Company Ltd,. London 1993; 3-10: 675-719.
- Jorge JMN, Wexner SD: Etiology and management of fecal incontinence. Dis Colon Rectum 1993; 36, 77-97.
- Nelson R, Spitz J, Pearl RK, et al.: What role does full rectal mobilization alone play in the treatment of rectal prolapse? Tech Coloproctol 2001; 5(1): 33-35.[Crossref]
- Worobiow G, Szełygin J, Titow A i wsp: Wyniki czynnościowe podwieszenia odbytnicy (rektopeksji). Proktologia 2001; Nr 3(4) Vol. 2; 254-62.
- Madoff RD, Williams JG, Wong WD, et al.: Longterm functional results of colon resection and rectopexy for overt rectal prolapse. Am J Gastroenterol 1992; 87: 101-04.
- Lucarotti ME, Armstrong CP: Control of presacral bleeding in rectal surgery. Ann R Coll Surg Engl 1991; 73: 289-90.
- Watts JD, Rothenberger DA, Buls JG, et al.: The management of procidentia: 30 years experience. Dis Colon Rectum 1985; 28: 96-102.
- Blatchford GJ, Perry RE, Thorson AG: Rectopexy without resection for rectal prolapse. Am J Surg 1989; 158: 574-76.
- Loygue J, Nordlinger B, Cunci O: Rectopexy to the promontory for the treatment of rectal prolapse: report of 257cases. Dis Colon Rectum 1984; 27: 356-59.[PubMed][Crossref]
- Sayfan J: Przezbrzuszna rektopeksja a zaparcie. Pol Przegl Chir 2000; 72(2): 113-20.
- Altemeier WA, Culberson WR: Nineteen years' experience with the one- stage perineal repair of rectal prolapse. Ann Surg 1971; 173: 993-1006.
- Thauerkauf FJ, Beahrs OH, Hill JR: Rectal prolapse causation and surgical treatment. Ann Surg 1970; 171: 819-35.
- Schlinkert RT, Beart RW, Wolf BG, et al.: Anterior resection for complete rectal prolapse. 1985; 28: 409-12.[PubMed]
- Gordon PH, Hoexter B: Complications of Ripstein procedure. Dis Colon Rectum 1978; 21: 277-80.[PubMed][Crossref]
- Frykman HM, Goldberg SM: The surgical treatment of rectal procidentia. Surg Gynecol Obstetr 1969; 129: 1225-30.
- Graham W, Clegg JF, Taylor V: Complete rectal prolapse repair by a simple technique. Ann R Coll Surg Engl 1984; 66: 87-89.
- Tracy L, Hull: Rectal prolapse. Proktologia 2003; Vol. 4.(Nr 1): 62-71.
- Parks AG, Swash M, Urich H: Sphincter denervation in anorectal incontinence and rectal prolapse. Gut 1977; 18: 656-65.
- Bell AM, Pemberton JH, Hanson RB, et al.: Variations in muscle tone of the human rectum:Recording with an an electromechanical barostat. Am J Physiol 1991; 260: 17-25.
- Yoshioka K, Hyland G, Keigley MRB: Anorectal function after abdominal rectopexy:parameters of predictive value in identifying return of continence. Br J Surg 1989; 76: 64-68.
- Hallan RI, Marzouk DEMM, Waldron DJ, et al.: Comparison of digital and manometric assessment of anal sphincter function. Br J Surg 1989; 76: 973-75.
- Wałęga P, Herman R, Popiela T: Odległe wyniki badań funkcji anorektalnych u chorych po przedniej resekcji odbytnicy. Pol Przegl Chir 2001; 73(4): 327-45.
- Hiltunen KM, Matikainen M, Anvinen O, et al.: Clinical and manometric evaluation of anal sphincter function in patients with rectal prolapse. Am J Surg 1986; 15: 489-92.
- Sayfan J, Koltun L, Orda R: Constipation in rectal prolapse the key to choosing the appropriate rectopexy. Tech in Coloproctology 1997.
- Douard R, Frileux P, Brunel M: Functional Results After the Orr-Loyque Transabdominal Rectopexy for Complete Rectal Prolapse. Dis Colon Rectum 2003; 46(8): 1089-96. AZ©©[PubMed][Crossref]
Publication order reference