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Recurrence after perineal rectosigmoidectomy: when and why?

M Kim1, J Reibetanz, N Schlegel

  • 1Department of General, Gastrointestinal, Vascular and Paediatric Surgery, University Hospital Wuerzburg, Wuerzburg, Germany.

Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland
|August 27, 2014
PubMed
Summary
This summary is machine-generated.

Recurrence after Altemeier's procedure for rectal prolapse is linked to stapled anastomosis and shorter specimen length. These factors increase the risk of full-thickness recurrence following perineal rectosigmoidectomy.

Keywords:
Altemeier's procedureExternal rectal prolapserecurrence

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Area of Science:

  • Colorectal Surgery
  • Surgical Outcomes Research

Background:

  • Perineal rectosigmoidectomy (Altemeier's procedure) is used for full-thickness rectal prolapse.
  • Recurrence rates after this surgery vary widely, from 0% to 60%.

Purpose of the Study:

  • To identify risk factors associated with recurrence after perineal rectosigmoidectomy for full-thickness rectal prolapse.

Main Methods:

  • A cohort of 63 patients undergoing perineal rectosigmoidectomy for full-thickness rectal prolapse was analyzed.
  • Patient characteristics and operative parameters were compared between those with and without recurrence.
  • Median follow-up was 53 months.

Main Results:

  • Eight full-thickness recurrences (12.7%) occurred after a median of 18 months.
  • Stapled anastomosis (HR 7.96) and shorter specimen length (HR 4.06) were significant risk factors for recurrence.
  • P-values were <0.001 for stapled anastomosis and 0.03 for specimen length.

Conclusions:

  • The operative technique, specifically stapled anastomosis, and the length of the resected specimen are associated with increased recurrence rates.
  • These findings suggest modifications to the surgical technique may reduce recurrence after perineal rectosigmoidectomy.