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Piozzi GN, Khobragade K, Shin SH, Choo JM, Kim SH. Treatment of side limb full-thickness prolapse of the side-to-end coloanal anastomosis following intersphincteric resection: a case report and review of literature. Ann Coloproctol 2024; 40:S38-S43. [PMID: 36751014 PMCID: PMC11162843 DOI: 10.3393/ac.2022.00829.0118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/29/2022] [Accepted: 12/29/2022] [Indexed: 02/09/2023] Open
Abstract
Intersphincteric resection (ISR) with coloanal anastomosis is an oncologically safe anus-preserving technique for very low-lying rectal cancers. Most studies focused on oncological and functional outcomes of ISR with very few evaluating long-term postoperative anorectal complications. Full-thickness prolapse of the neorectum is a relatively rare complication. This report presents the case of a 70-year-old woman presenting with full-thickness prolapse of the side limb of the side-to-end coloanal anastomosis occurring 2 weeks after the stoma closure and 2 months after a robotic partial ISR performed with the Da Vinci single-port platform. The anastomosis was revised through resection of the side limb and conversion of the side-to-end anastomosis into an end-to-end handsewn anastomosis with interrupted stitches. This study describes the first case of full-thickness prolapse of the side limb of the side-to-end handsewn coloanal anastomosis following ISR. Moreover, a revision of all reported cases of post-ISR full-thickness and mucosal prolapse was performed.
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Affiliation(s)
- Guglielmo Niccolò Piozzi
- Division of Colon and Rectal Surgery, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Krunal Khobragade
- Division of Colon and Rectal Surgery, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
- Department of Surgical Oncology, Alexis Multispecialty Hospital, Nagpur, India
| | - Seon Hui Shin
- Division of Colon and Rectal Surgery, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jeong Min Choo
- Division of Colon and Rectal Surgery, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Seon Hahn Kim
- Division of Colon and Rectal Surgery, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
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Habeeb TAAM, Podda M, Chiaretti M, Kechagias A, Lledó JB, Kalmoush AE, Mustafa FM, Nassar MS, Labib MF, Teama SRA, Elshafey MH, Elbelkasi H, Alsaad MIA, Sallam AM, Ashour H, Mansour MI, Mostafa A, Elshahidy TM, Yehia AM, Rushdy T, Ramadan A, Hamed AEM, Yassin MA, Metwalli AEM. Comparative study of laparoscopic ventral mesh rectopexy versus perineal stapler resection for external full-thickness rectal prolapse in elderly patients: enhanced outcomes and reduced recurrence rates-a retrospective cohort study. Tech Coloproctol 2024; 28:48. [PMID: 38619626 PMCID: PMC11018677 DOI: 10.1007/s10151-024-02919-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/16/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND In elderly patients with external full-thickness rectal prolapse (EFTRP), the exact differences in postoperative recurrence and functional outcomes between laparoscopic ventral mesh rectopexy (LVMR) and perineal stapler resection (PSR) have not yet been investigated. METHODS We conducted a retrospective multicenter study on 330 elderly patients divided into LVMR group (n = 250) and PSR (n = 80) from April 2012 to April 2019. Patients were evaluated before and after surgery by Wexner incontinence scale, Altomare constipation scale, and patient satisfaction questionnaire. The primary outcomes were incidence and risk factors for EFTRP recurrence. Secondary outcomes were postoperative incontinence, constipation, and patient satisfaction. RESULTS LVMR was associated with fewer postoperative complications (p < 0.001), lower prolapse recurrence (p < 0.001), lower Wexner incontinence score (p = 0.03), and lower Altomare's score (p = 0.047). Furthermore, LVMR demonstrated a significantly higher surgery-recurrence interval (p < 0.001), incontinence improvement (p = 0.019), and patient satisfaction (p < 0.001) than PSR. Three and 13 patients developed new symptoms in LVMR and PSR, respectively. The predictors for prolapse recurrence were LVMR (associated with 93% risk reduction of recurrence, OR 0.067, 95% CI 0.03-0.347, p = 0.001), symptom duration (prolonged duration was associated with an increased risk of recurrence, OR 1.131, 95% CI 1.036-1.236, p = 0.006), and length of prolapse (increased length was associated with a high recurrence risk (OR = 1.407, 95% CI = 1.197-1.655, p < 0.001). CONCLUSIONS LVMR is safe for EFTRP treatment in elderly patients with low recurrence, and improved postoperative functional outcomes. TRIAL REGISTRATION Clinical Trial.gov (NCT05915936), retrospectively registered on June 14, 2023.
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Affiliation(s)
- T A A M Habeeb
- Department of General Surgery, Faculty of Medicine, Zagazig University, 1 Faculty of Medicine Street, Zagazig, Sharqia, Egypt.
| | - M Podda
- Department of Surgical Science, Cagliari University Hospital, Monserrato, 09042, Cagliari, Italy
| | - M Chiaretti
- Paride Stefanini General and Specialist Surgery Department, Sapienza University of Rome IT, Rome, Italy
| | - A Kechagias
- Department of Gastroenterology and Alimentary Tract Surgery, Tampere, Finland
| | - J B Lledó
- Department of Surgery, La Fe University Hospital, Valencia, Spain
| | | | - Fawzy M Mustafa
- General Surgery Department, Faculty of Medicine, Al-Azher University, Cairo, Egypt
| | | | - Mohamed Fathy Labib
- General Surgery Department, Faculty of Medicine, Al-Azher University, Cairo, Egypt
| | | | | | - Hamdi Elbelkasi
- General Surgery Department, Mataryia Teaching Hospital (GOTHI), Cairo, Egypt
| | | | - Ahmed M Sallam
- Department of General Surgery, Faculty of Medicine, Zagazig University, 1 Faculty of Medicine Street, Zagazig, Sharqia, Egypt
| | - Hassan Ashour
- Department of General Surgery, Faculty of Medicine, Zagazig University, 1 Faculty of Medicine Street, Zagazig, Sharqia, Egypt
| | - Mohamed Ibrahim Mansour
- Department of General Surgery, Faculty of Medicine, Zagazig University, 1 Faculty of Medicine Street, Zagazig, Sharqia, Egypt
| | - Abdelshafy Mostafa
- Department of General Surgery, Faculty of Medicine, Zagazig University, 1 Faculty of Medicine Street, Zagazig, Sharqia, Egypt
| | - Tamer Mohamed Elshahidy
- Department of General Surgery, Faculty of Medicine, Zagazig University, 1 Faculty of Medicine Street, Zagazig, Sharqia, Egypt
| | - Ahmed M Yehia
- Department of General Surgery, Faculty of Medicine, Zagazig University, 1 Faculty of Medicine Street, Zagazig, Sharqia, Egypt
| | - Tamer Rushdy
- Department of General Surgery, Faculty of Medicine, Zagazig University, 1 Faculty of Medicine Street, Zagazig, Sharqia, Egypt
| | - Alaaedin Ramadan
- Department of General Surgery, Faculty of Medicine, Zagazig University, 1 Faculty of Medicine Street, Zagazig, Sharqia, Egypt
| | - Abd Elwahab M Hamed
- Department of General Surgery, Faculty of Medicine, Zagazig University, 1 Faculty of Medicine Street, Zagazig, Sharqia, Egypt
| | - Mahmoud Abdou Yassin
- Department of General Surgery, Faculty of Medicine, Zagazig University, 1 Faculty of Medicine Street, Zagazig, Sharqia, Egypt
| | - Abd-Elrahman M Metwalli
- Department of General Surgery, Faculty of Medicine, Zagazig University, 1 Faculty of Medicine Street, Zagazig, Sharqia, Egypt
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Baltazar JPA, Lopez MPJ, Onglao MAS. Neorectum prolapse after rectal cancer surgery corrected with perineal stapled prolapse resection. BMJ Case Rep 2022; 15:e246356. [PMID: 34983809 PMCID: PMC8728451 DOI: 10.1136/bcr-2021-246356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2021] [Indexed: 11/04/2022] Open
Abstract
A 61-year-old woman developed neorectal prolapse after laparoscopic low anterior resection, total mesorectal excision with partial intersphincteric resection and handsewn coloanal anastomosis for rectal cancer. She presented with a 3 cm full thickness reducible prolapse, with associated anal pain and bleeding. A perineal stapled prolapse resection was performed to address the rectal prolapse, with satisfactory results.
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Affiliation(s)
- Joanna Pauline A Baltazar
- Department of Surgery, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Marc Paul J Lopez
- Department of Surgery, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Mark Augustine S Onglao
- Department of Surgery, University of the Philippines-Philippine General Hospital, Manila, Philippines
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Fan K, Cao AM, Barto W, De Lacavalerie P. Perineal stapled prolapse resection for external rectal prolapse: a systematic review and meta-analysis. Colorectal Dis 2020; 22:1850-1861. [PMID: 32865320 DOI: 10.1111/codi.15338] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 08/18/2020] [Indexed: 12/29/2022]
Abstract
AIM Rectal prolapse is an uncommon but debilitating pelvic floor disorder that significantly decreases the quality of life of affected patients. Perineal stapled prolapse resection is a relatively new perineal approach that offers an promising alternative technique in the surgical management of rectal prolapse. It appears to be a simple, reproducible and efficient method. However, long-term outcomes are limited. The aims of this review are to assess the safety and effectiveness of perineal stapled prolapse resection in the management of rectal prolapse. METHOD A systematic review of all articles describing this approach was searched using MEDLINE, Embase, PubMed, Cochrane, Scopus, Web of Science and China National Knowledge Infrastructure. Included in this review were all randomized and nonrandomized prospective and retrospective studies reporting patients (aged 16 years and older) with complete rectal prolapse who underwent perineal stapled prolapse resection for the surgical treatment of the rectal prolapse. RESULTS A total of 408 patients across 20 articles were included. There were 58 cases of recurrence out of 368 patients over a median length of follow-up of 18 months (interquartile range 12-34 months). The total weighted overall recurrence was 12%. There were 51 cases of postoperative complications in 350 cases, bleeding being the most common complication. CONCLUSION The recurrence rate is comparable to those of the well-established Altemeier and Delorme procedures. However, given the heterogeneity of studies and variations in lengths of follow-up, further randomized prospective studies are needed to adequately compare this technique against other procedures for complete rectal prolapse.
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Affiliation(s)
- K Fan
- Colorectal Surgery department, Nepean Hospital, Kingswood, New South Wales, Australia
| | - A M Cao
- Colorectal Surgery department, Nepean Hospital, Kingswood, New South Wales, Australia
| | - W Barto
- Colorectal Surgery department, Nepean Hospital, Kingswood, New South Wales, Australia
| | - P De Lacavalerie
- Department of Surgery, Nepean Private Hospital, Kingswood, New South Wales, Australia.,University of Sydney Nepean Clinical School, Kingswood, New South Wales, Australia
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Laparoscopic Ventral Rectopexy Versus Stapled Transanal Rectal Resection for Treatment of Obstructed Defecation in the Elderly: Long-term Results of a Prospective Randomized Study. Dis Colon Rectum 2019; 62:47-55. [PMID: 30451760 DOI: 10.1097/dcr.0000000000001256] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Obstructed defecation is a common complaint in coloproctology. Many anal, abdominal, and laparoscopic procedures are adopted to correct the underlying condition. OBJECTIVE The purpose of this study was to compare long-term functional outcome, recurrence rate, and quality of life between laparoscopic ventral rectopexy and stapled transanal rectal resection in the treatment of obstructed defecation. DESIGN This was a prospective randomized study. SETTING This study was performed at academic medical centers. PATIENTS Patients were included if they had obstructed defecation attributed to pelvic structural abnormalities that did not to respond to conservative measures. Exclusion criteria included nonrelaxing puborectalis, previous abdominal surgery, other anal pathology, and pudendal neuropathy. INTERVENTION Patients were randomly allocated to either laparoscopic ventral rectopexy (group 1) or stapled transanal rectal resection (group 2). MAIN OUTCOME MEASURES The primary outcome measures were improvement of modified obstructed defecation score and recurrences after ≥3 years of follow-up. Secondary outcomes were postoperative complications, continence status using Wexner incontinence score, and quality of life using Patient Assessment of Constipation-Quality of Life Questionnaire. RESULTS The study included 112 patients (56 in each arm). ASA score II was reported in 32 patients (18 in group 1 and 14 in group 2; p = 0.12), whereas 3 patients in each group had ASA score III. Minor postoperative complications were seen in 11 patients (20%) of group 1 and 14 patients of group 2 (25%; p = 0.65). During follow-up, 3 patients had fecal urgency after stapled transanal rectal resection but no sexual dysfunction in either procedure. After 6 months, modified obstructed defecation score improvement >50% was reported in 73% versus 82% in groups 1 and 2 (p = 0.36). After a mean follow-up of 41 months, recurrences of symptoms were reported in 7% in group 1 versus 24% in group 2 (p = 0.04). Six months postoperation, perineal descent improved >50% in defecogram in 80% of group 1 versus no improvement in group 2. Quality of life significantly improved in both groups after 6 months; however a significant long-term drop (>36 months) was seen only in group 2. LIMITATIONS Possible limitations of this study are the presence of a single operator and the absence of blindness of the technique for both patient and assessor. CONCLUSIONS In elderly patients even with comorbidities, both laparoscopic ventral rectopexy and stapled transanal rectal resection are safe and can improve function of the anorectum in patients with obstructed defecation attributed to structural abnormalities. Laparoscopic ventral rectopexy has better long-term functional outcome, less complications, and less recurrences compared with stapled transanal rectal resection. Perineal descent only improves after laparoscopic ventral rectopexy. Stapled transanal rectal resection was shown not to be the first choice in elderly patients with obstructed defecation unless they had a medical contraindication to laparoscopic procedures. See Video Abstract at http://links.lww.com/DCR/A788.
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Özüner G, Benlice Ç. Perineal stapled rectal resection without a contour transtar: a modified approach. Turk J Surg 2018; 35:70-73. [PMID: 32550306 DOI: 10.5578/turkjsurg.3613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 03/03/2017] [Indexed: 11/15/2022]
Abstract
Perineal stapled prolapse resection is a novel approach for treating rectal prolapse in elderly and frail patients. This study aimed to report a modified technique using only a straight linear stapler. A 94-year-old female with 15-cm full thickness rectal prolapse was treated using a linear cutter in the left and right lateral quadrants, and then resection was completed by using the same instrument in the anterior and posterior flaps. The procedure was performed under local anesthesia and in a prone jackknife position. There was no morbidity or mortality, and the patient was discharged on postoperative day 2. Follow-up at 9 months revealed no recurrent prolapse, and the patient was asymptomatic. This technique is easy, safe, and fast to perform without using contour transtar (Ethicon Endo-Surgery, Cincinnati, OH).
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Affiliation(s)
- Gökhan Özüner
- New York Presbyterian, Cornell Brooklyn Methodist Hospital, New York, USA
| | - Çiğdem Benlice
- Department of Colorectal Surgery, Cleveland Clinic, Digestive Disease Institute, Cleveland, USA
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Operative Therapie des äußeren Rektumprolapses mit dem Stapler. COLOPROCTOLOGY 2017. [DOI: 10.1007/s00053-017-0188-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Raahave D, Jensen AK, Dammegaard L, Pedersen IK. Primary and repeated perineal stapled prolapse resection. Tech Coloproctol 2016; 20:853-857. [PMID: 27888440 DOI: 10.1007/s10151-016-1557-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 08/28/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Previous studies of the outcome after perineal stapled prolapse resection (PSPR) have included a limited number of patients with a short follow-up and high recurrence rates. The present study was designed to assess the initial results, complications, recurrence rate, and outcomes up to 4 years after PSPR, as well as the need for a repeated procedure. METHODS Fifty-four consecutive patients with rectal prolapse (mean age 77.2 years, range 46-93 years; n = 3 men) were selected for PSPR between May 2009 and February 2015. Prolapse length was measured at baseline and after surgery. Patients were asked to grade intensity of symptoms as a satisfaction score of 1-10, 10 representing being symptom-free. RESULTS The mean operation time was 45.3 min (SD = 17.5, range 25-95 min). The mean rectal prolapse length was reduced significantly from 9.5 cm (SD = 5.0, range 4-30 cm) to 1.2 cm (SD = 2.6, range 0-10 cm; p < 0.0001). Bleeding requiring surgical intervention occurred in two patients (3.7%). Postoperative satisfaction score increased from a mean of 2.2 (SD = 0.9) to a mean of 6.4 (SD = 2.8, p ≤ 0.0001). After a mean follow-up of 13.4 months (SD = 14.1), six patients with recurrence underwent a new PSPR and five patients underwent colostomy, mainly because of incontinence, resulting in a recurrence rate of 20.4%. There were no complications after redo PSPR, and after a median of 10-month follow-up (range 6-37), there were no recurrences. CONCLUSIONS PSPR is a rather new surgical procedure for external rectal prolapse. Immediate complications are few and not serious. Although recurrences can be treated with a second PSPR, the operation may only be the best option for old and fragile patients with comorbidities and a short life expectancy.
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Affiliation(s)
- D Raahave
- Department of Surgery, North Zealand Hospital, Copenhagen University, 3400, Hillerød, Denmark.
| | - A K Jensen
- Section of Biostatistics, Institute of Public Health, Copenhagen University, Copenhagen, Denmark
| | - L Dammegaard
- Department of Surgery, North Zealand Hospital, Copenhagen University, 3400, Hillerød, Denmark
| | - I K Pedersen
- Department of Surgery, North Zealand Hospital, Copenhagen University, 3400, Hillerød, Denmark
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Mistrangelo M, Tonello P, Brachet Contul R, Arnone G, Passera R, Grasso L, Rapetti L, Borroni R, Pozzo M, Roveroni M, Morino M, Perinotti R. Perineal stapled prolapse resection for full-thickness external rectal prolapse: a multicentre prospective study. Colorectal Dis 2016; 18:1094-1100. [PMID: 26969880 DOI: 10.1111/codi.13328] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 02/11/2016] [Indexed: 02/08/2023]
Abstract
AIM Many different surgical techniques have been reported for the surgical treatment of full-thickness external rectal prolapse. Perianal stapled prolapse resection (PSP) is a relatively newly reported technique for full thickness external rectal prolapse. The aim of this prospective multicentre study was to evaluate the results of this procedure. METHOD Consecutive patients who underwent a PSP resection for full-thickness external rectal prolapse at five centres were recruited to the study. Median operating time, hospital stay, complications, recurrence and functional results according to the Wexner Incontinence Scale and obstructive defaecation syndrome score were recorded. RESULTS There were 27 patients treated by PSP. The median Wexner incontinence score improved from 10 presurgery to 5 after surgery (P < 0.001); the median obstructed defaecation syndrome score improved from 12 presurgery to 5 (range 4-10) after surgery (P < 0.001). A laparoscopically assisted procedure was performed in three patients (11.1%). The median number of cartridges used was six (range four to nine). The median operating time was 48 min. Early complications occurred in six patients (22.2%) and late complications in two (7.4%). The median length of hospital stay was 5 days. The recurrence rate at a median follow-up of 30.3 months was 14.8%. CONCLUSION PSP appears to be an easy, fast and safe procedure. Early functional results are good. The recurrence rate compares favourably with other perineal procedures like the Delorme or the Altemeier operations. Long-term functional results need to be investigated further.
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Affiliation(s)
- M Mistrangelo
- Department of Surgical Sciences, Centre of Minimal Invasive Surgery, University of Turin, Turin, Italy.
| | - P Tonello
- Department of Surgery, Koelliker Hospital, Turin, Italy
| | | | - G Arnone
- Department of Surgery, Martini Hospital, Turin, Italy
| | - R Passera
- Nuclear Medicine Department, University of Turin, Turin, Italy
| | - L Grasso
- Department of Surgical Sciences, Centre of Minimal Invasive Surgery, University of Turin, Turin, Italy
| | - L Rapetti
- Department of Surgical Sciences, Centre of Minimal Invasive Surgery, University of Turin, Turin, Italy
| | - R Borroni
- Department of Surgery, Koelliker Hospital, Turin, Italy
| | - M Pozzo
- Department of Surgery, Biella Hospital, Biella, Italy
| | - M Roveroni
- Department of Surgery, Aosta Hospital, Aosta, Italy
| | - M Morino
- Department of Surgical Sciences, Centre of Minimal Invasive Surgery, University of Turin, Turin, Italy
| | - R Perinotti
- Department of Surgery, Biella Hospital, Biella, Italy
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Abstract
External rectal prolapse is a rare condition, which is more common in old and multimorbid women. In recent years five surgical methods have become established from among the multitude of operative procedures which have been described. One of the most recent techniques is perineal stapled prolapse resection (PSP) which is described in this article. After complete eversion of the rectal prolapse it is resected into 2 halves using a linear cutter by incisions at 3 o'clock and 9 o'clock lithotomy positions, followed by stepwise resection with a curved cutter along the ventral and dorsal circumference. There is low evidence for the treatment of external rectal prolapse. For PSP only case series exist with results that are similar to those from other techniques; however, comparative studies are nearly completely lacking. The PSP is a relatively new surgical technique for the treatment of external rectal prolapse. It is a safe surgical procedure. Due to the lack of evidence it should remain reserved for old and/or multimorbid patients.
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Affiliation(s)
- R Scherer
- Zentrum für Darm- und Beckenbodenchirurgie, Krankenhaus Waldfriede, Argentinische Allee 40, 14163, Berlin, Deutschland.
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Hummel B, Hardt J, Bischofberger S, Hetzer F, Warschkow R, Zadnikar M, Brunner W, Widmann B, Schmied B, Marti L. New kid on the block: perineal stapled prolapse resection (PSP) is it worthwhile in the long-term? Langenbecks Arch Surg 2016; 401:519-29. [DOI: 10.1007/s00423-016-1431-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 04/11/2016] [Indexed: 11/30/2022]
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Ram E, Krissi H, Zbar A, Atar E, Joubran S, Rath-Wolfson L. Perineal stapled prolapse resection (PSPR) in elderly patients for external rectal prolapse: early experience. Tech Coloproctol 2014; 18:1003-7. [DOI: 10.1007/s10151-014-1137-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 02/24/2014] [Indexed: 12/01/2022]
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Comments on Midterm results after perineal stapled prolapse resection for external rectal prolapse. Dis Colon Rectum 2013; 56:e365. [PMID: 23838875 DOI: 10.1097/dcr.0b013e318297d0e1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Petersen S, Schinkel B, Jürgens S, Taylessani C, Schwenk W. Impact of prolapse mass on Contour Transtar technique for third-degree rectal prolapse. Int J Colorectal Dis 2013; 28:1027-30. [PMID: 23371334 DOI: 10.1007/s00384-013-1649-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/21/2013] [Indexed: 02/04/2023]
Abstract
PURPOSE Contour Transtar procedure for rectal prolapse is a promising technique according to safety and efficacy. One potential surgical problem is failure of the stapler due to the thick rectal wall. In order to evaluate the practicability and the impending limitations of the Contour Transtar technique, we reviewed our data with special respect to the necessity of additional anastomosis suturing. METHODS A prospective analysis of 25 consecutive patients, which underwent Contour Transtar procedure from January 2009 to July 2012, was performed. For statistic analysis, the groups with and without additional suturing of the anastomosis were evaluated according to patient characteristics and surgical outcome. RESULTS Twenty-five patients, three men and 22 women, underwent transanal Contour Transtar stapling procedure for rectal prolapse. Due to stapling failure, additional suturing of the anastomosis was necessary in 4 of 25 procedures (16%). Age (74.1 vs. 83.1 years) and body mass index (30.8 vs. 22.7 kg/m(2)) were significantly different with and without additional suturing. Operative time was longer (62 vs. 31 min), more cartridges were used (12 vs. 6), and the specimen weight was higher (220 vs. 107 g) in patients with additional suturing. Early postoperative complications were observed in two patients without anastomosis suturing including one patient with bleeding and systemic inflammatory reaction in one case. Postoperative stay did not differ between both groups. CONCLUSION Patients with extensive obesity, which present with a substantial rectal prolapse, may need additional suturing of the rectal anastomosis after Contour Transtar stapling. This causes prolonged operative time. However, this does not correlate with complications and it is not related to significant longer hospital stay.
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Affiliation(s)
- Sven Petersen
- Department of General and Visceral Surgery, Asklepios Hospital Altona, Paul-Ehrlich-Str. 1, 22763 Hamburg, Germany.
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Perineal stapled prolapse resection for external rectal prolapse: is it worthwhile in the long-term? Tech Coloproctol 2013; 17:537-40. [DOI: 10.1007/s10151-013-1009-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Accepted: 03/28/2013] [Indexed: 10/26/2022]
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Pescatori M. External Rectal Prolapse. PREVENTION AND TREATMENT OF COMPLICATIONS IN PROCTOLOGICAL SURGERY 2012:183-196. [DOI: 10.1007/978-88-470-2077-1_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Pescatori M. Prolasso esterno del retto. PREVENZIONE E TRATTAMENTO DELLE COMPLICANZE IN CHIRURGIA PROCTOLOGICA 2011:185-199. [DOI: 10.1007/978-88-470-2062-7_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Gurland B, Zutshi M. Overview of Pelvic Evacuation Dysfunction. SEMINARS IN COLON AND RECTAL SURGERY 2010. [DOI: 10.1053/j.scrs.2009.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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