Experience of Altemeier's procedures for a complete rectal prolapse

Many patients with a complete rectal prolapse tend to be old. Therefore, surgeons tend to choose a surgical procedure associated with minimal stress. However, the recurrence rate is problematic. Altemeier's procedure causes minimal stress. This procedure is often selected for performing a complete rectal prolapse. Usually, a rectosigmoidectomy, is performed with levatoroplasty and anastomosis of the anal tube and the colon under spinal anesthesia. This procedure was applied for a complete rectal prolapse and the outcomes of this procedure were analyzed.

From 2000 August to 2006 January, 13 patients underwent this procedure. The patients ranged from 27 to 89 years of age (median 76 years). The length of the escaped enteric canal ranged from 7.0 to 20.0cm.

All patients underwent the procedure under spinal anesthesia. The surgical time was 113 +/- 20 minutes. There were two postoperative complications which were both treated conservatively. One recurrent case was recognized.

Altemeier's procedure was associated with a minimum of stress and the recurrence rate was low (7.6%). Because a complete rectal prolapse is caused by the fragility of the anal sphincter muscle and levator ani muscle, this procedure is considered to be effective and appropriate.