Rectal Prolapse
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Research conducted by M. Pescatori and co-researchers has updated our knowledge about rectal prolapse
2009 MAY 18 - (NewsRx.com) -- A new study, 'Tailored surgery for internal and external rectal prolapse: functional results of 268 patients operated upon by a single surgeon over a 21-year period*,' is now available. According to recent research from Rome, Italy, "Many procedures are used to treat internal (IRP) and external rectal prolapse (ERP). We report the outcome of surgery tailored in accordance with an evolving Unit algorithm over a 21-year period." "Two hundred and sixty-eight patients (151 IRP and 117 ERP) are reported. Perineal procedures (Delorme's mucosectomy, Altemeier's perineal rectosigmoidectomy) were used in frail elderly patients with ERP with abdominal sacrorectopexy or the Frykman-Goldberg procedure in fit patients. In IRP, prolapsectomy was most common with anterior hemi-Delorme's procedures for rectocele and levatorplasty for coincident faecal incontinence. Clinical and functional outcome was assessed over a median of 61 months (range 4-184 months). Postoperative mortality was 0.4%. For ERP, a perineal procedure was carried out in 75 (61.4%) cases with a 7.2% complication rate, postoperative incontinence in 20 (26.7%), constipation in four (5.3%) and recurrence in 12 (16%). For 42 abdominal procedures, the complication rate was 5% with incontinence in 7.1%, constipation in eight (19%) and recurrence in five (11.9%). A perineal operation was used in 89.4% of patients with IRP with incontinence in 10.6%, persistent constipation in 48 (52.7%) and recurrence in 25 (27.5%). The overall incontinence rate was 11% following abdominal and 24% following perineal procedures (p <0.05). Recurrence of ERP was significantly higher following a perineal operation (p <0.05). Tailored surgery for ERP achieves satisfactory results in terms of recurrence and functional outcome," wrote M. Pescatori and colleagues, . The researchers concluded: "For patients with IRP, perineal procedures are associated with a high incidence of recurrence and residual evacuatory difficulty." Pescatori and colleagues published their study in Colorectal Disease (Tailored surgery for internal and external rectal prolapse: functional results of 268 patients operated upon by a single surgeon over a 21-year period*. Colorectal Disease, 2009;11(4):410-9). For additional information, contact M. Pescatori, Ars Medica and Villa Flaminia Hospital, Coloproctology Unit, Rome, Italy. Publisher contact information for the journal Colorectal Disease is: Blackwell Publishing Inc., 350 Main St., Malden, MA 02148, USA. Keywords: Italy, Rome, Anal Incontinence, Colorectal Disease, Gastroenterology, Mucosectomy, Rectal Prolapse, Rectocele, Surgery, Urology. This article was prepared by Gastroenterology Week editors from staff and other reports. Copyright 2009, Gastroenterology Week via NewsRx.com.
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