Perineal stapled prolapse resection (PSPR) for external rectal prolapse in high morbidity patients

To demonstrated the efficacy an safety of a perineal stapled approach to treat the protrusion of the entire layer of the rectum outside the anus in high morbidity patients.

From February 2012 to april 2013, 7 patients (all female, mean age 74,2 years, range 48-88) were operated in our unit with perineal stapled prolapsed resection (PSPR) approach for a full thickness external rectal prolapse.

The duration of hospitalization was 3 days and the follow-up period was 18 months. There were no intraoperative complications and all patients had a bowel movement within 3 days of surgery. There was no mortality. None patients suffered of incontinence. Two patients (28,5%) had a recurrence and proctorragy after 18 months.

PSPR can be considered among perineal approaches for the treatment of full-thickness rectal prolapse. The reported rate of minor complications is low. No major complications have been described. Functional outcome is good, with marked improvement in both continence and constipation.

These results are better than those reported for other perineal procedures, although no randomized trials have yet been published. A multicenter study is needed to better evaluate the indications for and the outcome AFTER PSP.

Morbidity patients, Perineal stapled prolapse resection, Rectal prolapse.