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Lomas-Cooperman technique for rectal prolapse in the elderly patient
J E Mansilla1, G C Bannura, J P Contreras
1Department of Colorectal Surgery, Hospital San Borja Arriaran, Faculty of Medicine, University of Chile, Santiago.
Techniques in Coloproctology
|June 15, 2006
Summary
The Lomas-Cooperman technique for rectal prolapse (RP) in elderly patients is a simple surgical option. It shows acceptable morbidity and recurrence rates, improving incontinence in high-risk individuals.
Area of Science:
- Colorectal surgery
- Geriatric surgery
- Surgical techniques
Background:
- Complete rectal prolapse (RP) management involves various surgical procedures.
- Elderly patients with severe comorbidities present unique challenges for RP treatment.
Purpose of the Study:
- To analyze the immediate and long-term outcomes of the Lomas-Cooperman technique.
- To evaluate the efficacy and safety of this technique in high-risk elderly patients with symptomatic RP.
Main Methods:
- Retrospective evaluation of 22 elderly patients (mean age 84) with severe comorbidities undergoing the Lomas-Cooperman procedure.
- The technique involves perineal placement of a polypropylene mesh encircling the anal canal.
- Patients were assessed over a 13-year period with a mean follow-up of 32 months.
Main Results:
- Mean operative time was 35 minutes, with a mean hospital stay of 4.5 days.
- The most common immediate complication was urinary tract infection (18%). Mesh exteriorization occurred in 18% of cases, and recurrence was 4.5%.
- Significant improvement in preoperative incontinence scores (p<0.0001) was observed.
Conclusions:
- The Lomas-Cooperman technique is a simple, reproducible surgical option for elderly patients with RP and severe comorbidities.
- The procedure demonstrates acceptable morbidity and recurrence rates in this high-risk population.
- It offers a viable solution for managing symptomatic rectal prolapse in the elderly.