Strategy for selection of type of operation for rectal prolapse based on clinical criteria

Dis Colon Rectum. 2004 Jan;47(1):103-7. doi: 10.1007/s10350-003-0013-x. Epub 2004 Jan 2.

Abstract

Purpose: Reports of outcome after surgery for rectal prolapse predominantly relate to single operative procedures. A single surgical operation is not appropriate for all patients with rectal prolapse. We describe a selective policy based on clinical criteria.

Methods: Patients were offered surgery according to the following broad clinical protocol. Those who were unfit for abdominal surgery had a perineal operation. The remainder had a suture abdominal rectopexy. A sigmoid resection was added for patients in whom incontinence was not a predominant symptom.

Results: Surgery was performed in 159 patients. Of these, 57 had a perineal operation, 65 had fixation rectopexy, and 37 had resection rectopexy. There were no in-hospital deaths, and major complications occurred in five patients (3.5 percent). Minimum follow-up was 3 years. Of the 143 patients with long-term follow-up, recurrence occurred in 7 (5 percent). Constipation increased from 41 to 43 percent (59-61/143) and incontinence decreased from 43 to 19 percent (61 to 27/143).

Conclusions: A selective policy has improved outcome compared with reports of a single operation. Future studies might consider an objective method of selecting the type of operation for rectal prolapse.

MeSH terms

  • Abdomen / surgery*
  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Child
  • Digestive System Surgical Procedures*
  • Female
  • Follow-Up Studies
  • Health Status
  • Humans
  • Male
  • Middle Aged
  • Patient Selection*
  • Perineum / surgery*
  • Rectal Prolapse / surgery*
  • Rectum / surgery*
  • Treatment Outcome