Surgical Treatment of Complete Rectal Prolapse: Results of Abdominal and Perineal Approaches
| العنوان: | Surgical Treatment of Complete Rectal Prolapse: Results of Abdominal and Perineal Approaches |
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| المؤلفون: | P. Boccasanta, Ugo Cioffi, Alberto Peracchia, Matilde De Simone, Marco Venturi, Marco Montorsi, Riccardo Rosati |
| المساهمون: | P., Boccasanta, Rosati, Riccardo, M., Venturi, U., Cioffi, M., De Simone, M., Montorsi, A., Peracchia |
| المصدر: | Journal of Laparoendoscopic & Advanced Surgical Techniques. 9:235-238 |
| بيانات النشر: | Mary Ann Liebert Inc, 1999. |
| سنة النشر: | 1999 |
| مصطلحات موضوعية: | Adult, Male, Reoperation, medicine.medical_specialty, Perineoplasty, medicine.medical_treatment, Postoperative Complications, Colon, Sigmoid, Laparotomy, Reflex, Pressure, Humans, Medicine, Defecography, Fecal incontinence, Laparoscopy, Aged, Retrospective Studies, medicine.diagnostic_test, business.industry, General surgery, Anorectal manometry, Rectum, Rectal Prolapse, Middle Aged, medicine.disease, Surgery, Rectosigmoidectomy, Rectal prolapse, Treatment Outcome, Female, medicine.symptom, Gastrointestinal Motility, business, Follow-Up Studies |
| الوصف: | This retrospective study reports the results of our 5-year experience in the diagnosis and treatment of rectal prolapse with fecal incontinence by the abdominal (laparotomy or laparoscopy) and perineal approaches. Twenty-five patients (group A; 22 women and 3 men; mean age 57.3 years; range 22-76 years) were operated on by the abdominal approach and ten (group B; 8 women and 2 men; mean age 68.9 years; range 58-84 years) by the perineal approach. All patients were evaluated by clinical examination, proctosigmoidoscopy, pancolonic transit time, dynamic defecography, anorectal manometry, and anal electromyography preparatory to surgery. In patients of group A, we performed an abdominal rectopexy in 19 cases (7 by laparoscopy) and in the remaining 6 cases, a sigmoid resection-rectopexy (3 of which were by laparoscopy). All patients of group B were treated by a perineal operation using Delorme's mucosectomy in 4 cases and Altemeier's rectosigmoidectomy with total perineoplasty in 6 cases. The mean follow-up was 38.8 months in group A and 25.7 months in group B. The postoperative complication rate was 8% (two cases) in group A, whereas no significant complications occurred in group B. Dyschezia and fecal incontinence improved significantly in both groups (P < 0.05 in group A and P < 0.005 in group B), whereas anoperineal pain was not significantly reduced. At 1-year follow-up, the recurrences rates were 8% in group A and 30% in group B. Rectopexy or resection-rectopexy proved to be a safe and effective procedure for external prolapse, without a discernible difference between the laparotomic and laparoscopic techniques. In selected cases, the perineal approach gives good results regarding fecal incontinence without complications, even if in these patients, the likelihood of recurrence is high. |
| تدمد: | 1557-9034 1092-6429 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3f8a8d134adc0be01fe38d93bdd3d1c1Test https://doi.org/10.1089/lap.1999.9.235Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....3f8a8d134adc0be01fe38d93bdd3d1c1 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15579034 10926429 |
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