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Ripstein procedure is an effective treatment for rectal prolapse without constipation
J J Tjandra1, V W Fazio, J M Church
1Department of Colorectal Surgery, Cleveland Clinic Foundation, Ohio 44195.
Diseases of the Colon and Rectum
|May 1, 1993
Summary
The Ripstein procedure offers safe rectal prolapse repair with good outcomes, though constipation may persist or develop. Alternative surgeries may be better for patients with pre-existing constipation.
Area of Science:
- Colorectal surgery
- Gastroenterology
- Surgical outcomes
Background:
- Complete rectal prolapse surgical management remains debated.
- The Ripstein procedure is a common surgical approach.
Purpose of the Study:
- To evaluate the outcomes of the Ripstein procedure for complete rectal prolapse.
- To compare the Ripstein procedure with other surgical techniques.
Main Methods:
- Retrospective review of 169 patients undergoing 185 procedures over 27 years.
- Focus on the Ripstein procedure (n=142) and comparison with other methods.
- Analysis of recurrence, functional outcomes (incontinence, constipation), and patient satisfaction.
Main Results:
- Ripstein procedure had an 8% recurrence rate, with late recurrences observed.
- Fecal incontinence improved in about half of patients undergoing Ripstein or resection rectopexy.
- Constipation persisted or developed in a significant proportion of Ripstein patients, more so than with resection rectopexy.
Conclusions:
- The Ripstein procedure is safe and effective for anatomic correction of rectal prolapse and may improve continence.
- Alternative procedures may be preferable for patients with constipation.
- Patient dissatisfaction was noted in about one-third of cases, irrespective of the surgical method.