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Related Experiment Videos

Surgery for complete rectal prolapse in adults.

P Bachoo1, M Brazzelli, A Grant

  • 1Health Services Research Unit, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, Aberdeenshire, UK, AB25 2ZD. paul@pbachoo.freeserve.co.uk

The Cochrane Database of Systematic Reviews
|May 5, 2000
PubMed
Summary

Surgical treatment for rectal prolapse shows no clear best method due to limited trial data. Abdominal surgery may reduce fecal incontinence, but more research is needed for optimal surgical choices.

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Area of Science:

  • Gastroenterology
  • Colorectal Surgery
  • Surgical Outcomes Research

Background:

  • Complete rectal prolapse is a significant condition affecting all age groups, often leading to fecal incontinence.
  • The variety of surgical techniques for rectal prolapse necessitates an evaluation of their comparative effectiveness.

Purpose of the Study:

  • To assess the efficacy of surgical interventions for adult rectal prolapse.
  • To compare surgical approaches: abdominal vs. perineal, different rectopexy methods, laparoscopic vs. open surgery, and the inclusion of bowel resection.

Main Methods:

  • Systematic review of randomized and quasi-randomized controlled trials.
  • Searched multiple databases (Cochrane, Medline, Embase) and hand-searched key journals and conference proceedings up to March 1999.

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  • Primary outcomes included recurrence of prolapse, residual mucosal prolapse, and fecal incontinence.

    • Main Results:

    • Eight trials with 264 participants were included; no trials compared surgery to non-treatment.
    • No significant differences in prolapse recurrence between abdominal and perineal approaches, but abdominal surgery suggested less fecal incontinence.
    • Limited data precluded definitive comparisons for laparoscopic vs. open surgery and different rectopexy techniques.

    Conclusions:

    • The review's findings are limited by the small number and methodological weaknesses of the included trials.
    • Clinically significant differences between surgical options could not be established.
    • Larger, high-quality trials are essential to guide optimal surgical treatment for rectal prolapse.