Combined Thiersch's procedure and subanodermal coagulation for complete rectal prolapse in the elderly

Area of Science:

• Colorectal Surgery
• Gastroenterology

Background:

• Complete rectal prolapse management can be challenging, especially in high-risk patients.
• Thiersch's procedure is a traditional surgical approach for rectal prolapse.

Purpose of the Study:

• To evaluate a modified Thiersch's procedure using radiofrequency (RF) coagulation to induce fibrosis.
• To assess the safety and efficacy of this combined approach for complete rectal prolapse.

Main Methods:

• A radiofrequency device (Ellman generator) was used for circumferential subanodermal coagulation at the anal verge.
• Patients underwent a modified Thiersch's procedure combined with RF coagulation.
• Postoperative events and outcomes were recorded over a 2-year follow-up period.

Main Results:

• Two patients experienced postoperative complications: suppuration and wire loosening leading to recurrence.
• At 2-year follow-up, three patients had recurrence, and one reported persistent fecal incontinence.

Conclusions:

• The combined radiofrequency coagulation and Thiersch's wiring procedure is a rapid and straightforward technique.
• This modified approach presents low morbidity, making it suitable for elderly patients at high risk for major surgery.