Colonic resection in the treatment of complete rectal prolapse

For the good risk patient, nearly all surgeons recommend an abdominal approach as the surest method of eliminating a complete rectal prolapse. The most commonly performed abdominal procedures are rectal suspension-fixation operations utilizing slings of synthetic material or suture without foreign material. Occasionally both of these procedures are combined with a segmental colorectal resection. Rectal mobilization with fixation of the rectum to the sacrum alone, by whatever means, has a high rate of success with a low mortality and morbidity. The wisdom of adding colorectal resection to rectopexy in the treatment of complete rectal prolapse remains controversial. The authors favor abdominal rectopexy with sigmoid resection because it avoids foreign material, eliminates the risk of volvulus, improves bowel management problems, and has low morbidity with a low recurrence rate. In our series of 102 patients treated by rectopexy and sigmoid resection, there were no deaths and only 4 per cent morbidity related to the anastomosis. After a mean follow-up period of four years, the recurrence rate was 1.9 per cent.