Perineal stapled prolapse resection: a new procedure for external rectal prolapse

Area of Science:

• Colorectal surgery
• Surgical innovation
• Rectal prolapse treatment

Background:

• Rectal prolapse management often requires transabdominal surgery, which may not be suitable for all patients.
• Frail patients with rectal prolapse benefit from less invasive approaches.
• Transanal resection techniques have shown success in treating internal rectal redundancy.

Purpose of the Study:

• To present the surgical technique of perineal stapled prolapse resection (PSPR) for external rectal prolapse.
• To evaluate the feasibility and preliminary outcomes of PSPR in patients unsuitable for transabdominal surgery.
• To assess complications and reintervention rates associated with PSPR.

Main Methods:

• Prospective observational study conducted in two colorectal centers.
• Inclusion of patients not candidates for transabdominal rectal prolapse surgery.
• Assessment of operative feasibility, intraoperative and postoperative complications, and need for reintervention.

Main Results:

• Perineal stapled prolapse resection was successfully performed in 14 out of 15 patients.
• Median operative time was 33 minutes (range, 22-52 minutes).
• One patient required conversion to an Altemeier procedure; two patients needed reintervention for postoperative hemorrhage. No other severe complications were noted.

Conclusions:

• Perineal stapled prolapse resection is a novel, rapid, and technically straightforward surgical procedure for external rectal prolapse.
• The technique appears feasible and safe for selected frail patients.
• Further investigation is required to determine long-term functional outcomes and recurrence rates.