RECTAL PROLAPSE AND MANAGEMENT : A STUDY ON 30 CASES

Dr. Kurikala Raghu, Dr. Anil Mamidi, Dr. Chalamala Shyam Sunder Reddy

Abstract


Back ground: Rectal prolapse is protrusion of  part or whole rectum through the anal orifice. Management of this condition is challenging and there are different surgical approaches.

Aim: To evaluate and compare different surgical treatment modalities in treatment of rectal prolapse.

 

Materials and methods :Patients with full thickness prolapsed rectum , normal colonic transit and those found fit in ASI grade1 and grade 2 were selected for the study . Different surgical approaches were  reveiwed and the outcome in terms of recurrence and complications were evaluated.

 

Results: out of 30 cases, 21 cases underwent open abdominal procedures (in  which resection  rectopexy  for 9 cases and pre-sacral  rectopexy only for 12cases) and 6cases underwent perineal repair (altemeier-4 delorme-2),  3cases underwent laparoscopic (rectopexy-2,resection rectopexy-1).Average  hospitalisation was shorter for perineal  than abdominal procedures . Post op  complications and mortality were observed in  3cases  within  follow up of  6months,no mortality and no recurrence.

 

Conclusion:  The type of surgery for patients  with rectal prolapse should   be selected by taking patients overall condition and surgical experience   into account. In young patients, abdominal approach must be performed but  laparoscopic  approach has its advantage Altemeiers procedure shall be chosen in older patients  with low complication rate and recurrence.


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References


Yakut M, Kaymakcioglu N, Simsek A, Tan A, Sen D. Surgical treatment of rectal prolapse: a retrospective analysis of 94 cases. Int Surg. 1998;83:53–55.

Gourgiotis S, Baratsis S. Rectal prolapse. Int J Colorectal Dis. 2007;22:231–243.

Kairaluoma MV, Kellokumpu IH. Epidemiologic aspects of complete rectal prolapse. Scand J Surg. 2005;94:207–210.

Madiba TE, Baig MK, Wexner SD. Surgical management of rectal prolapse. Arch Surg. 2005;140:63–73.

Marceau C, Parc Y, Debroux E, Tiret E, Parc R. Complete rectal prolapse in young patients: psychiatric disease a risk factor of poor outcome. Colorectal Dis. 2005;7:360 –365.

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 –469.

Madoff RD, Mellgren A. One hundred years of rectal prolapse surgery. Dis Colon Rectum. 1999;42:441–450.

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.


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