scholarly journals Perineal Rectosigmoidectomy Associated with Low Colorectal Anastomosis for Complete Rectal Prolapse Correction – Altemeier’s Procedure

2020 ◽  
pp. 45-49
Author(s):  
Marcel Gutierrez ◽  
Anne Martinez ◽  
Sandra Di Felice Boratto
Keyword(s):  
Rectal Prolapse ◽  
Elderly Women ◽  
Colorectal Anastomosis ◽  
Life Quality ◽  
Complete Rectal Prolapse ◽  
Social Relevance ◽  
Surgical Interventions ◽  
Perineal Rectosigmoidectomy ◽  
Complications Rate

Introduction: Rectal prolapse constitutes in rectal protrusion through anal orifice. It’s more frequent in elderly women and the correction is exclusively surgical and fundamental, given the condition’s social relevance. We intend to describe a perineal rectosigmoidectomy (Altemeier) for correction of prolapse in multi-morbidity elder patient. Case Report: Female patient, 78 years old, evaluated by proctology ward of CHSBC. She Came in with complaint of anal region bulge for past 2 years. Proctological examination showed 15 cm rectal procidentia Rectal prolapse’s diagnosis came from colonoscopy. A perineal rectosigmoidectomy associated with colorectal anastomosis was done (Altemeier’s Procedure). There was appropriate postoperative evolution, discharge with good wound healing and ambulatorial follow up with good general healing. Discussion: Rectal prolapse is a result of anatomical alterations due to factors such as age and multiparity. Clinical presentation: abdominal discomfort, constipation, feces and gases release. It leads to life quality loss, thus surgical interventions become essential. Corrective surgeries seek to give back fecal continence. Currently, procedures branch out into abdominal and perineal. Altemeier consists in complete rectal removal via perineum. It’s appropriate for high surgical risk elders, since it has the lowest complications rate.

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

2004 ◽  
Vol 59 (4) ◽  
pp. 168-171 ◽  
Author(s):  
Carlos Walter Sobrado ◽  
Desidério Roberto Kiss ◽  
Sérgio C. Nahas ◽  
Sérgio E. A. Araújo ◽  
Victor E. Seid ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Fecal Incontinence ◽  
Rectal Prolapse ◽  
Late Results ◽  
Long Term Results ◽  
Complete Rectal Prolapse ◽  
Presacral Space ◽  
Perineal Rectosigmoidectomy ◽  
Study Results ◽  
Low Incidence

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.

scholarly journals High Grade Uterine and Rectal Prolapse

2016 ◽  
Vol 1 (2) ◽  
pp. 183-185
Author(s):  
Călin Molnar ◽  
Octavian-Sabin Tătaru ◽  
Vlad-Olimpiu Butiurcă ◽  
Varlam-Claudiu Molnar
Keyword(s):  
Rectal Prolapse ◽  
Elderly Women ◽  
Uterine Prolapse ◽  
Pelvic Organ ◽  
Case Presentation ◽  
Transvaginal Approach ◽  
Perineal Rectosigmoidectomy ◽  
Dilatation And Curettage ◽  
Manual Anastomosis ◽  
Manchester Procedure

Abstract Introduction: Pelvic floor hernias are encountered especially in elderly women. A combined genital, bladder, and rectal prolapse poses treatment challenges in aged women. Case presentation: We present the case of an 88 year-old patient, complaining of an intravaginal mass protruding for the last 3 months, rectal prolapse that occurred two weeks before admittance, accompanied by stress incontinence of urine and chronic constipation. Examination revealed a uterine prolapse with cystocele and a fourth grade rectal prolapse. We decided on a perianal and transvaginal approach, performing preliminary dilatation and curettage, cervix amputation, anterior colporrhaphy and colpoperineorrhaphy (Manchester procedure) with perineal rectosigmoidectomy using the LigaSure™ device, and coloanal manual anastomosis. Postoperatively the patient had no symptoms of stress urinary incontinence, bowel movement resumed in the fourth postoperative day, and the patient was discharged after seven days. One month after surgery the patient has both urinary and fecal continence, with no relapse in pelvic organ prolapse. Conclusions: Encountering genital, bladder, and rectal prolapse in the same patient is quite rare, and its treatment can be difficult in aged women. Therefore, a less invasive surgical procedure, using the transvaginal approach, and a genital sparing surgery could be the key in cases like this.

scholarly journals Classic bladder exstrophy and complete rectal prolapse in a 10 year-old child with no previous surgical intervention: what to achieve?

2020 ◽  
Vol 2020 (6) ◽  
Author(s):  
Nabila Salhab ◽  
Bardisan Gawrieh ◽  
Mohammad Ali Deeb ◽  
Norma Taishori ◽  
Ammar Omran
Keyword(s):  
Rectal Prolapse ◽  
Primary Closure ◽  
Surgical Intervention ◽  
Bladder Exstrophy ◽  
Complete Rectal Prolapse ◽  
Delayed Presentation ◽  
Socioeconomic Conditions ◽  
Operative Techniques ◽  
Surgical Interventions ◽  
Receive Treatment

Abstract The management of bladder exstrophy (BE) remains one of the most significant challenges encountered by pediatric urologists despite improvements in the operative techniques worldwide. Regardless of surgical technique, timing of primary closure remains a matter of debate. The initial closure may be performed within the first 48–72 hours of life or at ~6–12 weeks of age. Delayed presentation until adolescence is extremely rare. However, due to lack of awareness, and access to healthcare along with poor socioeconomic conditions in developing countries, some patients may not receive treatment during infancy. We present a case of a 10-year-old Syrian male with BE associated with complete rectal prolapse who did not undergo any previous surgical interventions.

scholarly journals Outcome of Delorme's Procedure for Full-Thickness Rectal Prolapse: Our experience in Bangabandhu Sheikh Mujib Medical University, Dhaka

2016 ◽  
Vol 10 (2) ◽  
pp. 55-58
Author(s):  
Tariq Akhtar Khan ◽  
Md Shahadot Hossain Sheikh ◽  
Md Abu Taher ◽  
Md Rayhanur Rahman ◽  
Md Rashidul Islam ◽  
...  
Keyword(s):  
Rectal Prolapse ◽  
Operative Time ◽  
Complete Rectal Prolapse ◽  
Full Thickness ◽  
Patient Reported ◽  
Delorme’S Procedure ◽  
The Mean ◽  
Medical University ◽  
Delorme's Procedure

The study was undertaken to determine the efficacy and safety profile of Delorme's procedure as the treatment for full-thickness rectal prolapse. In this study, outcome of Delorme's procedure for full-thickness rectal prolapse were assessed retrospectively. All the patients who underwent this surgery (22 patients) from July, 2013 to June, 2015 were included in the study. There were 18 males and 4 females with mean age of 37.4 years (range 12-70). The mean operative time was 92.6 minutes (Range 60-180 minutes). There was no mortality and blood loss was minimal. Mean hospital stay was 3.5 days (2-6 days). Outcomes of the procedure were satisfactory and no patient reported recurrence of the disease within the follow up period. Delorme's operation is safe and effective treatment for complete rectal prolapse in patients of all age and sex.Faridpur Med. Coll. J. Jul 2015;10(2): 55-58

scholarly journals Delorme’s Procedure for Complete Rectal Prolapse: A Study of Recurrence Patterns in the Long Term

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Carlos Placer ◽  
Jose M. Enriquez-Navascués ◽  
Ander Timoteo ◽  
Garazi Elorza ◽  
Nerea Borda ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rectal Prolapse ◽  
Recurrence Rate ◽  
Complete Rectal Prolapse ◽  
Kaplan Meier ◽  
Delorme’S Procedure ◽  
Recurrence Patterns ◽  
Delorme's Procedure

Introduction. The objective of this study was to determine the recurrence rate and associated risk factors of full-thickness rectal prolapse in the long term after Delorme’s procedure.Patients and Methods. The study involved adult patients with rectal prolapse treated with Delorme’s surgery between 2000 and 2012 and followed up prospectively in an outpatient unit. We assessed epidemiological data, Wexner constipation and incontinence score, recurrence patterns, and risk factors. Data were analyzed by univariate and multivariate studies and follow-up was performed according to Kaplan-Meier technique. The primary outcome was recurrence.Results. A total of 42 patients, where 71.4% (n=30) were women, with a median age of 76 years (IQR 66 to 86), underwent Delorme’s surgery. The median follow-up was 85 months (IQR 28 to 132). There was no mortality, and morbidity was 9.5%. Recurrence occurred in five patients (12%) within 14 months after surgery. Actuarial recurrence at five years was 9.9%. According to the univariate analysis, constipation and concomitant pelvic floor repair were the only factors found to be associated with recurrence. Multivariate analysis showed no statistically significant differences among variables studied. Kaplan-Meier estimate revealed that constipation was associated with a higher risk of recurrence (log-rank test,p=0.006).Conclusions. Delorme’s procedure is a safe technique with an actuarial recurrence at five years of 9.9%. The outcomes obtained in this study support the performance of concomitant postanal repair and levatorplasty to reduce recurrences. Also, severe constipation is associated with a higher recurrence rate.

Perineal rectosigmoidectomy with levatorplasty for complete rectal prolapse

2021 ◽  
Author(s):  
Esther María Cano Pecharromán ◽  
Juan Carlos Santiago Peña ◽  
A. Teresa Calderón Duque ◽  
Lourdes Gómez Ruiz ◽  
Felipe García Sánchez ◽  
...  
Keyword(s):  
Rectal Prolapse ◽  
Complete Rectal Prolapse ◽  
Perineal Rectosigmoidectomy

Incarcerated complete rectal prolapse managed by Altemeier’s procedure

2019 ◽  
Vol 50 (3) ◽  
pp. 236-238
Author(s):  
Narendra Pandit ◽  
Tek Narayan Yadav ◽  
Laligen Awale
Keyword(s):  
Rectal Prolapse ◽  
Anal Canal ◽  
Male Patient ◽  
Elderly Women ◽  
Rare Event ◽  
Complete Rectal Prolapse

Rectal prolapse is a complete protrusion of the rectum through the anal canal, which usually occurs in elderly women. Incarceration is a rare event and can be the first presentation of a rectal prolapse. We present the case of a 54-year-old male patient who presented with incarceration and was managed successfully with Altemeier’s procedure.

scholarly journals Complete Rectal Prolapse in Children: Case Report, Review of Literature, and Latest Trends in Management

2018 ◽  
Vol 6 (9) ◽  
pp. 1694-1696 ◽  
Author(s):  
Girish Gulab Meshram ◽  
Neeraj Kaur ◽  
Kanwaljeet Singh Hura
Keyword(s):  
Case Report ◽  
Rectal Prolapse ◽  
Surgical Intervention ◽  
Obstructed Defecation ◽  
Complete Rectal Prolapse ◽  
Review Of Literature ◽  
Fibre Diet ◽  
Stool Softener ◽  
High Fibre

BACKGROUND: Complete rectal prolapse is the circumferential descent of all the layers of the rectum through the anus. It often leads to bleeding, obstructed defecation, incarceration or fecal incontinence. CASE REPORT: We present a rare case of a 4-year-old child with complete rectal prolapse of 12 cm in length. The prolapsed rectum was manually repositioned after reducing the oedema. The precipitating factor was identified as excessive straining while passing stools. A change in position while passing stools was advised along with a high fibre diet and a stool softener. Recurrence was not observed in the 3 month of follow-up. CONCLUSION: Most cases of pediatric rectal prolapse are managed conservatively by addressing the associated and precipitating etiological factors. Surgical intervention may be required for recurrent or persistent cases.

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