Rectal prolapse: a 10-year experience.

Area of Science:

• Colorectal surgery
• Surgical outcomes research
• Gastrointestinal disease management

Background:

• Rectal prolapse is a condition requiring surgical intervention.
• Both perineal and abdominal approaches are utilized for surgical repair.
• Understanding long-term outcomes and comparative effectiveness is crucial for patient care.

Purpose of the Study:

• To compare the outcomes of perineal versus abdominal surgical procedures for rectal prolapse.
• To evaluate surgical techniques over a 10-year period at a single tertiary care institution.

Main Methods:

• Retrospective analysis of 75 patients undergoing surgery for primary rectal prolapse between 1995 and 2005.
• Procedures included perineal-based repairs (Altemeier, Delorme) and abdominal procedures (open/laparoscopic resection/rectopexy).
• Data abstracted included patient characteristics, surgical technique, hospitalization, morbidity, mortality, and recurrence rates.

Main Results:

• Perineal repairs were performed in 82.7% of patients, primarily older individuals.
• Average hospitalization was significantly shorter for perineal procedures (2.6 days) versus abdominal (4.8 days).
• Overall recurrence rate was 16%, with similar rates for both approaches (16.1% perineal, 15.4% abdominal); morbidity was 13% with no mortality.

Conclusions:

• Perineal procedures are more frequently utilized, particularly in older patients.
• Shorter hospital stays and comparable recurrence rates favor perineal repairs.
• Minimal morbidity and comparable efficacy suggest perineal procedures are a preferred option for rectal prolapse surgery.