Surgical treatment of rectal prolapse: experience and late results with 51 patients

The "best" surgical technique for the management of complete rectal prolapse remains unknown. Due to its low incidence, it is very difficult to achieve a representative number of cases, and there are no large prospective randomized trials to attest to the superiority of one operation over another. PURPOSE: Analyze the results of surgical treatment of complete rectal prolapse during 1980 and 2002. METHOD: Retrospective study. RESULTS: Fifty-one patients underwent surgical treatment during this period. The mean age was 56.7 years, with 39 females. Besides the prolapse itself, 33 patients complained of mucous discharge, 31 of fecal incontinence, 14 of constipation, 17 of rectal bleeding, and 3 of urinary incontinence. Abdominal operations were performed in 36 (71%) cases. Presacral rectopexy was the most common abdominal procedure (29 cases) followed by presacral rectopexy associated with sigmoidectomy (5 cases). The most common perineal procedure was perineal rectosigmoidectomy associated with levatorplasty (12 cases). Intraoperative bleeding from the presacral space developed in 2 cases, and a rectovaginal fistula occurred in another patient after a perineal rectosigmoidectomy. There were 2 recurrences after a mean follow-up of 49 months, which were treated by reoperation. CONCLUSION: Abdominal and perineal procedures can be used to manage complete rectal prolapse with safety and good long-term results. Age, associated medical conditions, and symptoms of fecal incontinence or constipation are the main features that one should bear in mind in order to choose the best surgical approach.

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Surgical Treatment of Complete Rectal Prolapse by the Moore Procedure – Short- and Long-Term Results

Digestive Surgery ◽

10.1159/000172584 ◽

1997 ◽

Vol 14 (5) ◽

pp. 409-412 ◽

Cited By ~ 1

Author(s):

Wojciech Tolwinski ◽

Henryk Dadan ◽

Bogdan Zalewski ◽

Bogna Okulczyk

Keyword(s):

Surgical Treatment ◽

Rectal Prolapse ◽

Long Term Results ◽

Complete Rectal Prolapse ◽

Short And Long Term

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Perineal rectosigmoidectomy: An effective approach for the repair of complete rectal prolapse

Annals of the College of Surgeons Hong Kong ◽

10.1046/j.1442-2034.2000.00042.x ◽

2000 ◽

Vol 4 (1) ◽

pp. 13-16

Author(s):

KM Chiu ◽

AK AhChong ◽

AWC Yip

Keyword(s):

Rectal Prolapse ◽

Complete Rectal Prolapse ◽

Perineal Rectosigmoidectomy

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Problems of surgical treatment of the anterior pelvic ring chronic injuries

Practical medicine ◽

10.32000/2072-1757-2021-3-47-54 ◽

2021 ◽

Vol 19 (3) ◽

pp. 47-54

Author(s):

A. F. LAZAREV ◽

◽

E. I. SOLOD ◽

YA. G. GUDUSHAURI ◽

E. I. KALININ ◽

...

Keyword(s):

Surgical Treatment ◽

Pelvic Ring ◽

Metal Structure ◽

Complex Problem ◽

Long Term Results ◽

Fixation Method ◽

Surgical Interventions ◽

Anterior Section ◽

Pelvic Injuries ◽

Study Results

A surgical treatment of the joints of the pelvic ring, especially the pubic joint is a separate and complex problem. When using standard plates, which are applied in the treatment of patients with fresh injuries to stabilize old injuries of the pelvic ring, problems arise with fatigue fracture of plates, destabilization of the metal structure and the need for repeated surgical interventions. Therefore, in the case of old injuries, during surgical treatment, it is necessary to use other tactical approaches to fixing pelvic injuries and to search for adapted structures for such cases. The purpose — to study the features of fixation of old injuries of the pelvic ring and to determine the results of different methods of the anterior pelvis fixation in old cases. Materials and methods. A retrospective analysis of the performed surgical treatment was carried out. In 2000-2015, in the first department of National Medical Research Center of Traumatology and Orthopedics named after N.N. Priorov, 117 patients underwent surgical treatment of old injuries of the anterior pelvic ring under our supervision using standard reconstructive plates applied in the surgical treatment of new injuries of the pelvic ring. Results. Of the 65 patients who underwent fixation of an old injury of the anterior semiring with AO reconstructive plates and AO pelvic plates, installed in a standard manner as in new injuries, 12 patients (10,2%) experienced migration or fracture of structures within 2 to 6 months from the operation. In 52 patients, fixation of the anterior section with two AO plates was applied, one of which was located in a standard way along the upper edge of the pubic bones, the second was implanted additionally along the anterior surface of the pelvic ring perpendicular to the first one. In this group, migration and destabilization of the structures was observed in 7 patients (13,4%) within a period from 2 weeks to 2 months from the date of the operation. Conclusion. The analysis of the study results suggests that surgical treatment of old injuries of the anterior pelvic ring requires a special approach to the choice of the surgical fixation method, which differs from the treatment of new injuries. Over time, in the absence of treatment for injuries and ruptures of the pelvic ring, cicatricial-fibrous adhesions of the pelvic ring occur, which does not always ensure the stability of the pelvic ring, but leads to rigid post-traumatic deformity of the pelvis. Taking into account the cases of destabilization in groups 1 — 10,2% and 2 — 13,4%, as well as the assessment of the long-term results according to the Majeed scale, the use of standard methods for fixing the anterior pelvic semiring can be considered ineffective in old pelvic injuries.

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Surgical Treatment of Complete Rectal Prolapse: Results of Abdominal and Perineal Approaches

Journal of Laparoendoscopic & Advanced Surgical Techniques ◽

10.1089/lap.1999.9.235 ◽

1999 ◽

Vol 9 (3) ◽

pp. 235-238 ◽

Cited By ~ 20

Author(s):

PAOLO BOCCASANTA ◽

RICCARDO ROSATI ◽

MARCO VENTURI ◽

UGO CIOFFI ◽

MATILDE DE SIMONE ◽

...

Keyword(s):

Surgical Treatment ◽

Rectal Prolapse ◽

Complete Rectal Prolapse

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Surgical treatment of pulmonary sequestration in adults and children: long-term results

Interactive CardioVascular and Thoracic Surgery ◽

10.1093/icvts/ivaa054 ◽

2020 ◽

Vol 31 (1) ◽

pp. 71-77

Author(s):

Beatrice Trabalza Marinucci ◽

Giulio Maurizi ◽

Camilla Vanni ◽

Giuseppe Cardillo ◽

Camilla Poggi ◽

...

Keyword(s):

Surgical Treatment ◽

Respiratory Symptoms ◽

Pulmonary Sequestration ◽

Adult Patients ◽

Long Term Results ◽

Study Results ◽

Group A ◽

Group B ◽

Histological Results

Abstract OBJECTIVES Few experiences comparing paediatric and adult patients treated for pulmonary sequestration (PS) have been reported. Surgical treatment is considered the best choice, but the time of surgery is still controversial. We present our experience in this setting, comparing characteristics, histological results and outcome of paediatric and adult patients undergoing PS resection. METHODS Between 1998 and 2017, a total of 74 patients underwent lobectomy or sublobar resection for PS. Sixty patients were children (group A: ≤16 years old) and 14 were adults (group B: >16 years old). Preoperative diagnosis was radiological. PS was intralobar (42 cases) and extralobar (32 cases). The operation was a muscle-sparing lateral thoracotomy or video-assisted thoracoscopic surgery. Preoperative characteristics, histological results and short-/long-term results of the 2 groups were retrospectively analysed and compared. RESULTS Thirty-seven percent of the patients in group A presented with respiratory symptoms and 79% in group B (P = 0.44). Most symptomatic patients were treated with a lobectomy. In group A, 2 patients (3%) had a malignant transformation of the lesion. Patients with a prenatal diagnosis treated after the age of 1 year became more symptomatic than those operated on before the age of 1 year (57% vs 23%; P = 0.08). No differences were found in postoperative complications. Long-term stable remission of respiratory symptoms was obtained in 91% of patients in group A and 100% in group B. Adulthood (P = 0.03) and the association with congenital cystic adenomatoid malformation (P = 0.03) were negative prognostic factors for the development of respiratory symptoms. CONCLUSIONS Surgical treatment of PS is safe and feasible. Despite the small number of patients included, study results indicated that an early operation during childhood may prevent the subsequent development of respiratory symptoms. Surgical treatment is also recommended to prevent the rare transformation into malignancy.

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