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Colonic transit before and after resection rectopexy for full-thickness rectal prolapse

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Abstract

Background

The objective of this study was to measure the change in colonic transit time after resection rectopexy for complete rectal prolapse.

Methods

We prospectively carried out isotope colonic transit studies before resection rectopexy in 38 patients with full-thickness complete rectal prolapse and invited them to attend for a postoperative transit study at least 1 year after resection rectopexy.

Results

Preoperatively, 27 (70 %) patients had abnormally prolonged colonic transit times, while 11 had normal colonic transit. Twenty-two (61 %) patients agreed to attend for a three-day colonic transit study. Resection rectopexy failed to correct delayed colonic transit in all patients with abnormal preoperative tests, while 4 patients developed new delayed transit and 2 with normal transit were unchanged.

Conclusions

The study suggests that most prolapse patients have a pan-colonic motility disorder that is not corrected by rectopexy and resection of most of the left colon. If resection rectopexy fails to correct abnormal transit, this study questions the rationale for continuing to offer resection and supports less invasive surgical procedures such as ventral rectopexy.

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References

  1. Kim DS, Tsang CB, Wong WD, Lowry AC, Goldberg SM, Madoff RD (1999) Complete rectal prolapse: evolution of management and results. Dis Colon Rectum 42:460–466

    Article  CAS  PubMed  Google Scholar 

  2. Azimuddin K, Khubchandani IT, Rosen L, Stasik JJ, Riether RD, Reed JF 3rd (2001) Rectal prolapse: a search for the “best” operation. Am Surg 67:622–627

    CAS  PubMed  Google Scholar 

  3. Cirocco WC (2010) The Altemeier procedure for rectal prolapse: an operation for all ages. Dis Colon Rectum 53:1618–1623

    Article  PubMed  Google Scholar 

  4. Kim M, Reibetanz J, Boenicke L, Germer CT, Jayne D, Isbert C (2010) Quality of life after transperineal rectosigmoidectomy. Br J Surg 97:269–272

    Article  CAS  PubMed  Google Scholar 

  5. Farouk R, Duthie GS, Bartolo DC, MacGregor AB (1992) Restoration of continence following rectopexy for rectal prolapse and recovery of the internal anal sphincter electromyogram. Br J Surg 79:439–440

    Article  CAS  PubMed  Google Scholar 

  6. Madden MV, Kamm MA, Nicholls RJ, Santhanam AN, Cabot R, Speakman CT (1992) Abdominal rectopexy for complete prolapse: prospective study evaluating changes in symptoms and anorectal function. Dis Colon Rectum 35:48–55

    Article  CAS  PubMed  Google Scholar 

  7. Sayfan J, Pinho M, Alexander-Williams J, Keighley MR (1990) Sutured posterior abdominal rectopexy with sigmoidectomy compared with Marlex rectopexy for rectal prolapse. Br J Surg 77:143–145

    Article  CAS  PubMed  Google Scholar 

  8. Huber FT, Stein H, Siewert JR (1995) Functional results after treatment of rectal prolapse with rectopexy and sigmoid resection. World J Surg 19:138–143

    Article  CAS  PubMed  Google Scholar 

  9. Brown AJ, Nicol L, Anderson JH, McKee RF, Finlay IG (2005) Prospective study of the effect of rectopexy on colonic motility in patients with rectal prolapse. Br J Surg 92:1417–1422

    Article  CAS  PubMed  Google Scholar 

  10. Luukkonen P, Mikkonen U, Järvinen H (1992) Abdominal rectopexy with sigmoidectomy vs. rectopexy alone for rectal prolapse: a prospective, randomized study. Int J Colorectal Dis 7:219–222

    Article  CAS  PubMed  Google Scholar 

  11. Notghi A, Mills A, Hutchinson R, Kumar D, Harding LK (1995) Reporting simplified colonic transit studies using radionuclides: clinician friendly reports. Gut 36:274–275

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  12. Notghi A, Hutchinson R, Kumar D, Smith NB, Harding LK (1994) Simplified method for the measurement of segmental colonic transit time. Gut 35:976–981

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  13. Metcalf AM, Phillips SF, Zinsmeister AR, MacCarty RL, Beart RW, Wolff BG (1987) Simplified assessment of segmental colonic transit. Gastroenterology 92:40–47

    CAS  PubMed  Google Scholar 

  14. Madiba TE, Baig MK, Wexner SD (2005) Surgical management of rectal prolapse. Arch Surg 140:63–73

    Article  PubMed  Google Scholar 

  15. Kuijpers HC (1992) Treatment of complete rectal prolapse: to narrow, to wrap, to suspend, to fix, to encircle, to plicate or to resect? World J Surg 16:826–830

    Article  CAS  PubMed  Google Scholar 

  16. Speakman CT, Madden MV, Nicholls RJ, Kamm MA (1991) Lateral ligament division during rectopexy causes constipation but prevents recurrence: results of a prospective randomized study. Br J Surg 78:1431–1433

    Article  CAS  PubMed  Google Scholar 

  17. Mollen RM, Kuijpers JH, van Hoek F (2000) Effects of rectal mobilization and lateral ligaments division on colonic and anorectal function. Dis Colon Rectum 43:1283–1287

    Article  CAS  PubMed  Google Scholar 

  18. Watts JD, Rothenberger DA, Buls JG, Goldberg SM, Nivatvongs S (1985) The management of procidentia. 30 years’ experience. Dis Colon Rectum 28:96–102

    Article  CAS  PubMed  Google Scholar 

  19. Wijffels N, Cunningham C, Dixon A, Greenslade G, Lindsey I (2011) Laparoscopic ventral rectopexy for external rectal prolapse is safe and effective in the elderly. Does this make perineal procedures obsolete? Colorectal Dis 13:561–566

    Article  CAS  PubMed  Google Scholar 

  20. Dinning PG, Bampton PA, Andre J et al (2004) Abnormal predefecatory colonic motor patterns define constipation in obstructed defecation. Gastroenterology 127:49–56

    Article  PubMed  Google Scholar 

  21. Orr TG (1947) A suspension operation for prolapse of rectum. Ann Surg 126:833–837

    Article  PubMed Central  Google Scholar 

  22. Loygue J, Cerbonnet G (1957) Surgical treatment of total prolapse of the rectum by rectopexy following the Orr technic; based on 14 case reports. Mem Acad Chir 83:325–329

    CAS  PubMed  Google Scholar 

  23. D’Hoore A, Penninckx F (2006) Laparoscopic ventral recto(colpo)pexy for rectal prolapse: surgical technique and outcome for 109 patients. Surg Endosc 20:1919–1923

    Article  PubMed  Google Scholar 

  24. Samaranayake CB, Luo C, Plank AW, Merrie AE, Plank LD, Bissett IP (2010) Systematic review on ventral rectopexy for rectal prolapse and intussusception. Colorectal Dis 12:504–512

    Article  CAS  PubMed  Google Scholar 

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Correspondence to M. S. El Muhtaseb.

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El Muhtaseb, M.S., Bartolo, D.C.C., Zayiae, D. et al. Colonic transit before and after resection rectopexy for full-thickness rectal prolapse. Tech Coloproctol 18, 273–276 (2014). https://doi.org/10.1007/s10151-013-1053-4

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  • DOI: https://doi.org/10.1007/s10151-013-1053-4

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