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Complete rectal prolapse: evolution of management and results
1Department of Surgery, University of Minnesota School of Medicine, Minneapolis, USA.
Diseases of the Colon and Rectum
|April 24, 1999
Summary
Surgical treatment for complete rectal prolapse involves a trade-off. Abdominal rectopexy offers lower recurrence, while perineal rectosigmoidectomy has less morbidity but higher recurrence rates.
Area of Science:
- Colorectal surgery
- Gastrointestinal surgery
- Surgical outcomes research
Background:
- Complete rectal prolapse treatment remains controversial.
- Surgical intervention is common, but optimal technique is debated.
Purpose of the Study:
- To evaluate surgical trends, recurrence rates, and functional outcomes for complete rectal prolapse over a 19-year period.
- To compare abdominal rectopexy with perineal rectosigmoidectomy.
Main Methods:
- Retrospective review of 372 patients undergoing surgery for complete rectal prolapse (1976-1994).
- Follow-up via questionnaires and interviews to assess functional results.
- Analysis of surgical approach, patient demographics, morbidity, and recurrence.
Main Results:
- Perineal rectosigmoidectomy increased in popularity over time, favored for patients with comorbidities.
- Abdominal rectopexy had lower recurrence rates (5% vs. 16%) but longer hospital stays.
- Morbidity rates were similar between procedures; functional outcomes and patient satisfaction were comparable.
Conclusions:
- Abdominal rectopexy with bowel resection is associated with significantly lower recurrence rates.
- Perineal rectosigmoidectomy offers reduced morbidity and shorter hospital stays but higher recurrence.
- Perineal rectosigmoidectomy may be suitable for high-risk elderly patients, while younger patients must weigh recurrence risk against procedural ease.