Comparison of Delorme-Thiersch Operation Outcomes in Men and Women With Rectal Prolapse

Abstract Background Treatment options for complete rectal prolapse include over 100 procedures. In previous reports, operative rectal prolapse repair, regardless of the technique by perineal approach, was associated with high recurrence rates. However, there is no consensus on the optimal surgical procedure for relapsed rectal prolapse. Case presentation A 97-year-old woman was admitted to our hospital with a chief complaint of complete rectal prolapse measuring > 5 cm. The patient had a history of laparoscopic anterior suture rectopexy without sigmoid resection under general anesthesia for complete rectal prolapse one year prior. The patient’s postoperative course was uneventful. However, her dementia worsened (Hasegawa’s dementia scale: 5/30 points) after the first operation. Further, moderate-to-severe aortic valve stenosis was first diagnosed with heart failure 6 months after the operation. Nine months after the initial surgery, she experienced a recurrence of complete rectal prolapse measuring approximately 5 cm. Considering the coexistence of advanced age, severe dementia, and aortic valve stenosis, surgery under general anesthesia was not indicated. Perineal stapled prolapse resection in combination with the t operation was planned because of its minimal invasiveness and shortened hospital stay. The procedure was performed by a team of two surgeons in the jack knife position, under spinal anesthesia. The prolapse was cut along the long-axis direction with three linear staplers and resected along the short-axis direction with four linear staplers. The cross-section of the linear stapler was reinforced with 3-0 Vicryl sutures. After rectal resection, the Thiersch operation using 1-0 nylon thread 1 cm away from the anal verge was additionally performed. The operative time was 24 min, and intraoperative blood loss was 1 mL. The postoperative course was uneventful. Three months after the operation, no recurrence was observed, and defecation function was good with improvements of Wexner score. Conclusions Perineal stapled prolapse resection in combination with the Thiersch operation could be a useful option for patients with relapsed rectal prolapse and with poor general condition, who are not indicated for other surgical procedures.

Download Full-text

A modified thiersch operation for complete rectal prolapse using a teflon prosthesis

Diseases of the Colon & Rectum ◽

10.1007/bf02617326 ◽

1963 ◽

Vol 6 (3) ◽

pp. 192-195 ◽

Cited By ~ 11

Author(s):

Benjamin Haskell ◽

Harold Rovner

Keyword(s):

Rectal Prolapse ◽

Complete Rectal Prolapse ◽

Thiersch Operation

Download Full-text

The thiersch operation for rectal prolapse

Diseases of the Colon & Rectum ◽

10.1007/bf02616848 ◽

1964 ◽

Vol 7 (5) ◽

pp. 383-385 ◽

Cited By ~ 4

Author(s):

William B. Gabriel

Keyword(s):

Rectal Prolapse ◽

Thiersch Operation

Download Full-text

Ultrastructural comparison of prolactin adenomas of pituitary in men and women

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100103796 ◽

1988 ◽

Vol 46 ◽

pp. 346-347

Author(s):

R.C. Caughey ◽

U.P. Kalyan-Raman

Keyword(s):

Endoplasmic Reticulum ◽

Electron Microscope ◽

Phosphate Buffer ◽

Pituitary Adenomas ◽

Osmium Tetroxide ◽

Secretory Granules ◽

Uranyl Acetate ◽

En Bloc ◽

Men And Women ◽

Transmission Electron

Prolactin producing pituitary adenomas are ultrastructurally characterized by secretory granules varying in size (150-300nm), abundance of endoplasmic reticulum, and misplaced exocytosis. They are also subclassified as sparsely or densely granulated according to the amount of granules present. The hormone levels in men and women vary, being higher in men; so also the symptoms vary between both sexes. In order to understand this variation, we studied 21 prolactin producing pituitary adenomas by transmission electron microscope. This was out of a total of 80 pituitary adenomas. There were 6 men and 15 women in this group of 21 prolactinomas.All of the pituitary adenomas were fixed in 2.5% glutaraldehyde, rinsed in Millonig's phosphate buffer, and post fixed with 1% osmium tetroxide. They were then en bloc stained with 0.5% uranyl acetate, rinsed with Walpole's non-phosphate buffer, dehydrated with graded series of ethanols and embedded with Epon 812 epoxy resin.

Download Full-text

Race Difference in Auditory Sensitivity

Journal of Speech and Hearing Research ◽

10.1044/jshr.0704.389 ◽

1964 ◽

Vol 7 (4) ◽

pp. 389-393 ◽

Cited By ~ 3

Author(s):

David C. Shepherd ◽

Robert Goldstein ◽

Benjamin Rosenblüt

Keyword(s):

White Women ◽

White Men ◽

Sensitivity Study ◽

Auditory Sensitivity ◽

Race Difference ◽

Men And Women ◽

Auditory Thresholds ◽

Békésy Audiometry ◽

Method Of Adjustment ◽

Better Than

Two separate studies investigated race and sex differences in normal auditory sensitivity. Study I measured thresholds at 500, 1000, and 2000 cps of 23 white men, 26 white women, 21 negro men, and 24 negro women using the method of limits. In Study II thresholds of 10 white men, 10 white women, 10 negro men, and 10 negro women were measured at 1000 cps using four different stimulus conditions and the method of adjustment by means of Bekesy audiometry. Results indicated that the white men and women in Study I heard significantly better than their negro counterparts at 1000 and 2000 cps. There were no significant differences between the average thresholds measured at 1000 cps of the white and negro men in Study II. White women produced better auditory thresholds with three stimulus conditions and significantly more sensitive thresholds with the slow pulsed stimulus than did the negro women in Study II.

Download Full-text