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Related Experiment Videos

Rectal prolapse: a search for the "best" operation.

K Azimuddin1, I T Khubchandani, L Rosen

  • 1Department of Surgery, Lehigh Valley Hospital, Allentown, Pennsylvania, USA.

The American Surgeon
|July 14, 2001
PubMed
Summary

Abdominal procedures for rectal prolapse offer the lowest recurrence rates but involve higher complication risks. Perineal proctosigmoidectomy (PPS) is a viable option for selected patients, demonstrating minimal morbidity and acceptable recurrence rates.

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Area of Science:

  • Colorectal Surgery
  • Surgical Gastroenterology

Background:

  • Optimal surgical treatment for full-thickness rectal prolapse remains debated.
  • Rectal prolapse (procidentia) management requires careful consideration of surgical approaches.

Purpose of the Study:

  • To evaluate the outcomes of different surgical techniques for rectal prolapse.
  • To assess the efficacy and safety of perineal proctosigmoidectomy (PPS) versus abdominal procedures (anterior resection [AR] and Ripstein procedure [RP]).

Main Methods:

  • Retrospective review of 65 patients undergoing surgery for rectal prolapse between 1989 and 1999.
  • Comparison of outcomes between 36 patients who underwent PPS and 29 patients who had abdominal procedures (17 AR, 12 RP).

Main Results:

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  • Patients undergoing PPS were older with more comorbidities; they experienced shorter operating times and hospital stays.
  • The PPS group had significantly lower postoperative complication rates compared to abdominal procedures.
  • Recurrence rates were 16% for PPS at a mean follow-up of 50 months, with no recurrences reported after AR or RP.

    • Conclusions:

    • Abdominal procedures (AR, RP) yield the lowest recurrence rates for rectal prolapse but are associated with higher complication costs.
    • Perineal proctosigmoidectomy (PPS) is a valuable surgical option for selected rectal prolapse patients, offering minimal morbidity and a relatively low recurrence rate.