Functional outcome after perineal stapled prolapse resection for external rectal prolapse.

Area of Science:

• Colorectal Surgery
• Surgical Innovation
• Pelvic Floor Disorders

Background:

• External rectal prolapse presents a significant challenge in colorectal surgery.
• The Perineal Stapled Prolapse resection (PSP) was introduced in 2008 as a novel surgical approach.
• This study evaluates the mid-term functional outcomes of a larger patient cohort undergoing PSP.

Purpose of the Study:

• To assess the efficacy and safety of the Perineal Stapled Prolapse resection (PSP) for external rectal prolapse.
• To evaluate the functional outcomes, particularly concerning fecal incontinence and constipation, following PSP.
• To present mid-term follow-up data from a larger patient group.

Main Methods:

• PSP was performed on patients with external rectal prolapse by a dedicated surgical team.
• The technique involved axial resection of the prolapse using linear and curved staplers.
• Perioperative morbidity and functional outcomes were prospectively measured using validated scoring systems.

Main Results:

• 32 patients with a median age of 80 years underwent the procedure.
• Low complication rates were observed: no intraoperative and 6.3% minor postoperative complications.
• Significant improvement in fecal incontinence was noted, with 90% of patients experiencing resolution and a median Wexner score reduction from 16 to 1 (P < 0.0001).

Conclusions:

• The Perineal Stapled Prolapse resection (PSP) is a safe and effective surgical option for external rectal prolapse.
• The procedure demonstrates excellent functional results, particularly in resolving fecal incontinence.
• PSP is characterized as an elegant, fast, and safe surgical technique.