Durable Approaches to Recurrent Rectal Prolapse Repair May Require Avoidance of Index Procedure

Area of Science:

• Colorectal surgery
• Pelvic floor disorders

Background:

• Recurrent rectal prolapse presents unique surgical challenges due to prior interventions.
• Existing data are limited for determining optimal surgical approaches in cases of recurring prolapse.

Purpose of the Study:

• To evaluate current surgical strategies for patients with a history of rectal prolapse repair.
• To compare short-term outcomes, including recurrence rates, between initial (de novo) and repeat (redo) prolapse surgeries.

Main Methods:

• Retrospective analysis of a prospective, multicenter quality improvement database.
• Inclusion of de-identified data from over 25 high-volume surgical sites.
• Comparison of outcomes between patients undergoing primary repair versus re-repair for rectal prolapse.

Main Results:

• Nearly 20% of patients (89/461) underwent redo rectal prolapse repair.
• Short-term follow-up showed similar recurrence rates for redo versus de novo repairs.
• Redo procedures typically involved a different surgical technique than the initial operation.

Conclusions:

• Surgical correction of recurrent rectal prolapse is achievable with comparable short-term durability to primary repairs.
• Consideration of alternative surgical approaches for redo procedures may be warranted.
• Further research into optimal surgical techniques for recurrent prolapse is needed.