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Perineal Stapled Prolapse Resection.

Prasang Bajaj1, Sachin Wani1, Pervez Sheikh1

  • 1Department of GI and Minimal access surgery, Joy Hospital, 423 AB, 10th Road, Chembur, Mumbai, 400071 India.

The Indian Journal of Surgery
|March 25, 2016
PubMed
Summary

Perineal stapled prolapse resection offers a safe and effective treatment for rectal prolapse. This new surgical technique improved patient outcomes, including fecal incontinence and constipation, with minimal complications.

Keywords:
PerinealProlapseRectal prolapseResectionStapled

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Area of Science:

  • Gastroenterology
  • Colorectal Surgery
  • Surgical Innovation

Background:

  • External rectal prolapse is a condition requiring effective surgical intervention.
  • Traditional surgical methods carry risks, including potential nerve damage.
  • A novel technique, perineal stapled prolapse resection, was introduced in 2007.

Purpose of the Study:

  • To evaluate the safety and efficacy of perineal stapled prolapse resection for full-thickness rectal prolapse.
  • To assess functional outcomes, complications, and procedural efficiency.
  • To determine the suitability of this technique for elderly patients with comorbidities and younger patients concerned about nerve damage.

Main Methods:

  • Prospective study of 12 patients with full-thickness rectal prolapse between January 2010 and April 2012.
  • Inclusion criteria: rectal prolapse up to 8-10 cm, elderly patients with comorbidities, and young patients seeking to avoid nerve damage risks.
  • Assessment of functional outcomes, complications, operating time, and hospital stay.

Main Results:

  • Median operating time was 45 minutes, with a median hospital stay of 3 days.
  • No major complications occurred; one patient had a small extraperitoneal collection managed conservatively.
  • Significant improvement in preoperative fecal incontinence (90%) and constipation (66%) was observed.
  • No de novo onset or worsening of constipation was reported.
  • At a median follow-up of 36 months, all patients were well with no early recurrence.

Conclusions:

  • Perineal stapled prolapse resection is a safe, easy, and quick surgical procedure for external rectal prolapse.
  • The technique demonstrates good functional outcomes and a low complication rate.
  • It is a viable option for selected patients with rectal prolapse.