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Surgical management of rectal prolapse.
A Michalopoulos1, V N Papadopoulos, S Panidis
1First Propedeutic Surgical Department, Aristotle's University of Thessaloniki, AHEPA Hospital, T Oikonomidi 21, Kalamaria, 551 31 Thessaloniki, Greece.
Surgical management of rectal prolapse in 27 elderly patients showed varied outcomes. Most patients experienced symptom relief, but some required emergency procedures or experienced recurrence, highlighting the need for tailored treatment approaches.
Area of Science:
- Colorectal Surgery
- Gastroenterology
Background:
- Rectal prolapse, encompassing full-thickness, mucosal, and internal prolapse, is underreported, particularly in the elderly.
- The true incidence of rectal prolapse remains unknown due to significant underreporting.
Purpose of the Study:
- To present surgical management experiences for rectal prolapse.
- To analyze outcomes of various surgical procedures for rectal prolapse.
Main Methods:
- A 6-year study (2004-2010) involving 27 patients (25 women, 2 men) with a mean age of 72.36 years.
- Surgical procedures included Delorme's, STARR (Stapled TransAnal Rectal Resection), Wells, Wells combined with Thiersch, Altemeier, sigmoid resection with Wells, and Thiersch.
Main Results:
- One patient required emergency sigmoidostomy post-Wells operation for obstructive ileus.
- One death occurred due to pulmonary embolism on postoperative day 5.
- Two recurrences were noted 8 months postoperatively (one STARR, one Thiersch); most patients achieved symptom relief.
Conclusions:
- Treatment for rectal prolapse requires diverse modalities due to varying causes, degrees, and symptoms.
- Successful surgical outcomes depend on preoperative anal sphincter status, prolapse type (internal/external), and overall patient condition.
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