Comparison of abdominal and perineal approach for recurrent rectal prolapse

Rectal prolapse is a benign disease in which the rectum protrudes below the anus. Although many studies have been reported on the treatment of primary rectal prolapse for many years, there is a lack of treatment or clinical research results on recurrent rectal prolapse. This study aimed to evaluate the outcomes of surgical approaches for recurrent rectal prolapse.

We studied patients who underwent surgical treatment for recurrent rectal prolapse disease from March 2016 to February 2021. We analyzed the previous operation methods in patients with recurrent rectal prolapse, as well as the operation time, complication rate, hospital stay, and re-recurrence rates in the perineal and abdominal approach groups.

Out of a total of 239 patients, 41 patients who underwent surgery for recurrent rectal prolapse were retrospectively enrolled. Recurrent rectal prolapses were surgically treated either by the perineal approach (n = 25, 61.0%) or by the abdominal approach (n = 16, 39.0%). The operation times were significantly longer in the abdominal approach than in the perineal approach (98.44 minutes vs. 58.00 minutes, P = 0.001). Hospital stay was significantly longer in the abdominal approach than in the perineal approach (9.19 days vs. 6.00 days, P = 0.012). Re-recurrence rate after repeat repair was not significantly different between the 2 groups (P = 0.777).

Although the perineal approach shortened the operation time and hospital stay, there were no significant differences between the 2 groups in postoperative complications and re-recurrence rate. Both approaches can be good surgical options for the treatment of recurrent rectal prolapse.