Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 86 (5), 249-55

Comparison of Abdominal and Perineal Procedures for Complete Rectal Prolapse: An Analysis of 104 Patients

Affiliations

Comparison of Abdominal and Perineal Procedures for Complete Rectal Prolapse: An Analysis of 104 Patients

Jong Lyul Lee et al. Ann Surg Treat Res.

Abstract

Purpose: Selecting the best surgical approach for treating complete rectal prolapse involves comparing the operative and functional outcomes of the procedures. The aims of this study were to evaluate and compare the operative and functional outcomes of abdominal and perineal surgical procedures for patients with complete rectal prolapse.

Methods: A retrospective study of patients with complete rectal prolapse who had operations at a tertiary referral hospital and a university hospital between March 1990 and May 2011 was conducted. Patients were classified according to the type of operation: abdominal procedure (AP) (n = 64) or perineal procedure (PP) (n = 40). The operative outcomes and functional results were assessed.

Results: The AP group had the younger and more men than the PP group. The AP group had longer operation times than the PP group (165 minutes vs. 70 minutes; P = 0.001) and longer hospital stays (10 days vs. 7 days; P = 0.001), but a lower overall recurrence rate (6.3% vs. 15.0%; P = 0.14). The overall rate of the major complication was similar in the both groups (10.9% vs. 6.8%; P = 0.47). The patients in the AP group complained more frequently of constipation than of incontinence, conversely, in the PP group of incontinence than of constipation.

Conclusion: The two approaches for treating complete rectal prolapse did not differ with regard to postoperative morbidity, but the overall recurrence tended to occur frequently among patients in the PP group. Functional results after each surgical approach need to be considered for the selection of procedure.

Keywords: Abdomen; Perineum; Procedure; Rectal prolapse.

Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Pre- and postoperative manometric results in the abdominal (A) and perineal procedure (B) groups. The postoperative values were generally obtained between three and six months after the operation. For both groups, the mean maximal resting pressure (MRP) after the operation was higher than the preoperative MRP. The other manometric values did not changed significantly in either group. MSP, maximal squeezing pressure; MSV, minimal sensory volume; UV, urgent need to defecate volume; MTV, maximal tolerance volume; SL, sphincter length; HPZ, high-pressure zone.

Similar articles

See all similar articles

Cited by 2 PubMed Central articles

References

    1. Riansuwan W, Hull TL, Bast J, Hammel JP, Church JM. Comparison of perineal operations with abdominal operations for full-thickness rectal prolapse. World J Surg. 2010;34:1116–1122. - PubMed
    1. Schultz I, Mellgren A, Dolk A, Johansson C, Holmstrom B. Long-term results and functional outcome after Ripstein rectopexy. Dis Colon Rectum. 2000;43:35–43. - PubMed
    1. Kim DS, Tsang CB, Wong WD, Lowry AC, Goldberg SM, Madoff RD. Complete rectal prolapse: evolution of management and results. Dis Colon Rectum. 1999;42:460–466. - PubMed
    1. Luukkonen P, Mikkonen U, Jarvinen H. Abdominal rectopexy with sigmoidectomy vs. rectopexy alone for rectal prolapse: a prospective, randomized study. Int J Colorectal Dis. 1992;7:219–222. - PubMed
    1. Finlay IG, Aitchison M. Perineal excision of the rectum for prolapse in the elderly. Br J Surg. 1991;78:687–689. - PubMed
Feedback