[Intraoperative pitfalls and complications in defecation disorders and rectal prolapse]

Area of Science:

• Coloproctology
• Surgical Gastroenterology

Background:

• No definitive gold standard exists for operative rectal prolapse therapy.
• Individualized surgical approaches are crucial for optimal patient outcomes.
• Understanding operative pitfalls and complication management is vital for successful treatment.

Purpose of the Study:

• To analyze intraoperative pitfalls and complications (iPCM) in patients undergoing individualized surgical treatment for rectal prolapse and rectocele.
• To evaluate the management and outcomes of these iPCMs.

Main Methods:

• A consecutive series of 233 patients with rectal prolapse and rectocele were treated between June 2011 and May 2016.
• Treatment involved an individualized choice of operative procedure guided by a clinical pathway and stapled hemorrhoidopexy.
• Intraoperative pitfalls and complications (iPCM) were prospectively documented and analyzed.

Main Results:

• Of 233 patients, 34 experienced intraoperative pitfalls and complications (iPCM).
• Group I (n=20): iPCM managed intraoperatively with no impact on clinical course.
• Group II (n=9): iPCM managed conservatively with rapid recovery.
• Group III (n=5): iPCM required surgical revision.

Conclusions:

• Specialized coloproctology units are essential for individualized rectal prolapse and rectocele treatment.
• A clinical treatment pathway aids in selecting the optimal surgical procedure.
• While complication rates are low, awareness of specific risks and prompt management strategies lead to favorable outcomes in most cases.