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Primary and repeated perineal stapled prolapse resection.

D Raahave1, A K Jensen2, L Dammegaard3

  • 1Department of Surgery, North Zealand Hospital, Copenhagen University, 3400, Hillerød, Denmark. dr.dr@dadlnet.dk.

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Summary

Perineal stapled prolapse resection (PSPR) offers initial symptom relief for rectal prolapse, but a significant recurrence rate necessitates careful patient selection. Redo PSPR can be effective for recurrent cases.

Keywords:
External rectal prolapsePerineal approachPerineal stapled prolapse resectionRectopexy

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Area of Science:

  • Colorectal Surgery
  • Surgical Outcomes
  • Gastroenterology

Background:

  • Previous studies on Perineal Stapled Prolapse Resection (PSPR) reported limited patient numbers and high recurrence rates.
  • This study aimed to evaluate the outcomes of PSPR, including initial results, complications, and recurrence rates up to four years.

Purpose of the Study:

  • To assess the efficacy and safety of Perineal Stapled Prolapse Resection (PSPR) for external rectal prolapse.
  • To determine the long-term outcomes, recurrence rates, and the need for repeat procedures after PSPR.

Main Methods:

  • Fifty-four patients with rectal prolapse underwent Perineal Stapled Prolapse Resection (PSPR).
  • Pre- and post-operative prolapse length measurements were recorded.
  • Patient satisfaction was assessed using a 1-10 scoring system.

Main Results:

  • PSPR significantly reduced rectal prolapse length (9.5 cm to 1.2 cm) with a mean operation time of 45.3 minutes.
  • Postoperative patient satisfaction scores improved significantly (2.2 to 6.4).
  • A 20.4% recurrence rate was observed, with redo PSPR showing no complications or recurrences in a median 10-month follow-up.

Conclusions:

  • Perineal Stapled Prolapse Resection (PSPR) is associated with few immediate complications and improved patient satisfaction.
  • While redo PSPR is feasible for recurrences, the procedure may be best suited for elderly, frail patients with comorbidities and limited life expectancy.