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Related Experiment Videos

Rectal prolapse: which surgical option is appropriate?

T H K Schiedeck1, O Schwandner, J Scheele

  • 1Department of Surgery, University Clinic of Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.

Langenbeck'S Archives of Surgery
|March 9, 2004
PubMed
Summary

Choosing the best surgical treatment for rectal prolapse remains unclear. While transabdominal procedures show promise for reduced recurrence and better continence, further randomized trials are needed to define optimal surgical approaches.

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Area of Science:

  • Colorectal Surgery
  • Gastrointestinal Surgery

Background:

  • Rectal prolapse treatment involves various surgical options.
  • Perineal approaches are common for high-risk patients but have high recurrence and incontinence rates.
  • Transabdominal procedures may offer better functional outcomes but carry risks.

Purpose of the Study:

  • To evaluate the effectiveness of different surgical treatments for rectal prolapse.
  • To compare functional outcomes and recurrence rates between surgical approaches.
  • To highlight the need for standardized definitions and randomized trials.

Main Methods:

  • Review of existing literature on surgical treatments for rectal prolapse.
  • Discussion of outcomes for perineal (Delorme's, Altemeier's) and transabdominal (rectopexy, resection-rectopexy) procedures.

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  • Consideration of laparoscopic resection-rectopexy outcomes.

    • Main Results:

    • Transabdominal procedures are associated with lower recurrence and improved continence compared to perineal approaches.
    • Laparoscopic resection-rectopexy appears safe and effective with favorable recurrence rates.
    • Current evidence is limited by a lack of standardized definitions and diagnostic assessments.

    Conclusions:

    • The optimal surgical treatment for rectal prolapse is not definitively established.
    • Further high-quality randomized trials are essential to guide clinical practice.
    • Standardization of diagnostic criteria and surgical techniques is crucial for future research.