Lomas-Cooperman technique for rectal prolapse in the elderly patient

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.