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Primary and repeated perineal stapled prolapse resection

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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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References

  1. Scherer R, Marti L, Hetzer F (2008) Perineal stapled prolapse resection: a new procedure for external rectal prolapse. Dis Colon Rectum 51:1727–1730

    Article  PubMed  Google Scholar 

  2. Romano G, Bianco F, Caggiano L (2009) Modified perineal stapled rectal resection with contour transtar for full thickness rectal prolapse. Colorectal Dis 11:878–881

    Article  CAS  PubMed  Google Scholar 

  3. Tschuor C, Limani P, Nocito A, Dindo D, Clavien PA, Hahnloser D (2013) Perineal stapled prolapse resection for external rectal prolapse: is it worthwhile in the long-term? Tech Coloproctol 17:537–540

    Article  CAS  PubMed  Google Scholar 

  4. Ram E, Krissi H, Zbar A, Atar E, Joubran S, Rath-wolfson L (2014) Perineal stapled prolapse resection (PSPR) in elderly patients for external rectal prolapse: early experience. Tech Coloproctol 18:1003–1007

    Article  CAS  PubMed  Google Scholar 

  5. Hetzer FH, Roushan AH, Wolf K et al (2010) Functional outcome after perineal stapled prolapse resection for external rectal prolapse. BMC Surg 10:9

    Article  PubMed  PubMed Central  Google Scholar 

  6. Sehmer D, Marti L, Wolf K, Hetzer FH (2013) Midterm results after perineal stapled prolapse resection for external rectal prolapse. Dis Colon Rectum 56:91–96

    Article  PubMed  Google Scholar 

  7. Raahave D, Christensen E, Loud FB, Knudsen LL (2009) Correlation of bowel symptoms with colonic transit, length, and faecal load in functional faecal retention. Dan Med Bull 56:83–88

    PubMed  Google Scholar 

  8. Raahave D, Loud FB, Christensen E, Knudsen LL (2010) Colectomy for refractory constipation. Scand J Gastroenterol 45:592–602

    Article  PubMed  Google Scholar 

  9. Kimmins MH, Evetts BK, Isler J, Billingham R (2001) The Altemeier repair: outpatient treatment of rectal prolapse. Dis Colon Rectum 44:565–570

    Article  CAS  PubMed  Google Scholar 

  10. Boccasanta P, Venturi M, Barbieri S, Roviario G (2006) Impact of new technologies on the clinical and functional outcome of Altemeier’s procedure: a randomized, controlled trial. Dis Colon Rectum 49:652–660

    Article  PubMed  Google Scholar 

  11. Cirocco WC (2010) The Altemeier procedure fore rectal prolapse: an operation for all ages. Dis Colon Rectum 53:1618–1623

    Article  PubMed  Google Scholar 

  12. Bruch HP, Herold A, Schidek T, Schwandner O (1999) Laparoscopic surgery for rectal prolapse and outlet obstruction. Dis Colon Rectum 42:1189–1194

    Article  CAS  PubMed  Google Scholar 

  13. Wilson J, Engledow A, Crosbie J, Arulampalam T, Motson R (2011) Laparoscopic nonresectional suture rectopexy in the management of full-thickness rectal prolapse: substantive retrospective series. Surg Endosc 25:1062–1064

    Article  PubMed  Google Scholar 

  14. Zittel TT, Manncke K, Haug S et al (2000) Functional results after laparoscopic rectopexy for rectal prolapse. J Gastrointest Surg 4:632–641

    Article  CAS  PubMed  Google Scholar 

  15. Boons P, Collinson R, Cunningham C, Lindsey I (2010) Laparoscopic ventral rectopexy for external rectal prolapse improves constipation and avoids de novo constipation. Colorectal Dis 12:526–532

    Article  CAS  PubMed  Google Scholar 

  16. van Geleuwe B, Wolthuis A, Penninckx F, D´Hoore A (2013) Lessons learned after more than 400 laparoscopic ventral rectopexies. Acta Chir Belg 113:103–106

    Google Scholar 

  17. Raahave D, Jepsen LV, Pedersen IK (2008) Primary and repeated stapled hemorrhoidopexy for prolapsing hemorrhoids: follow-up to five years. Dis Colon Rectum 51:334–341

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, North Zealand Hospital, Copenhagen University, 3400, Hillerød, Denmark

    D. Raahave, L. Dammegaard & I. K. Pedersen

  2. Section of Biostatistics, Institute of Public Health, Copenhagen University, Copenhagen, Denmark

    A. K. Jensen

Authors
  1. D. Raahave
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  2. A. K. Jensen
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  3. L. Dammegaard
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  4. I. K. Pedersen
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Correspondence to D. Raahave.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the present study involving human participants were performed in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was given orally.

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Raahave, D., Jensen, A.K., Dammegaard, L. et al. Primary and repeated perineal stapled prolapse resection. Tech Coloproctol 20, 853–857 (2016). https://doi.org/10.1007/s10151-016-1557-9

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  • DOI: https://doi.org/10.1007/s10151-016-1557-9

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