Advertisement

Surgery for Rectal Prolapse: Functional Outcome from the Perineal Approach — An Overview

  • Steven D. Wexner
  • Amit Khanna

Abstract

Numerous approaches to the treatment of rectal prolapse have been described throughout the history of medicine. Rectal prolapse is often associated with functional disorders such as constipation and/or incontinence [1]. Recognition of this association and careful evaluation of baseline function is critical to providing appropriate therapy. Both abdominal and perineal variants of rectal prolapse repair have been examined in a growing body of literature. These reports have intended to determine both short- and long-term functional outcomes associated with a multitude of approaches to rectal prolapse surgery. This overview provides evidence to aid the clinician in surgical decision making when faced with the patient in need of operative repair. Surgical therapy of rectal prolapse is often not standard, but rather, tailored after careful consideration of the patient’s operative risk, life expectancy, associated functional disorders, and previous operative history.

Keywords

Rectal Prolapse Squeeze Pressure Perineal Approach Pudendal Nerve Terminal Motor Latency Perineal Descent 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Jorge JM, Wexner SD (1993) Etiology and management of fecal incontinence. Dis Colon Rectum 36:76–97Google Scholar
  2. 2.
    Broden B, Snellman B (1968) Procidentia of the rectum studied with cineradiography: a contribution to the discussion of causative mechanism. Dis Colon Rectum 11:330–347PubMedCrossRefGoogle Scholar
  3. 3.
    Parks AG, Porter NH, Hardcastle J (1966) The syndrome of the descending perineum. Proc R Soc Med 59:477–482PubMedGoogle Scholar
  4. 4.
    Kiff ES, Barnes PRH, Swash M (1984) Evidence of pudendal neuropathy in patients with perineal descent and chronic straining at stool. Gut 25:1279–1282PubMedCrossRefGoogle Scholar
  5. 5.
    Fazio VW (2005) Current therapy in colon and rectal surgery. Mosby, Philadelphia, pp 131–134Google Scholar
  6. 6.
    Birnbaum EH, Stamm L, Rafferty JF (1996) Pudendal nerve terminal motor latency influences surgical outcome in treatment of rectal prolapse. Dis Colon Rectum 39(11):1215–1221PubMedCrossRefGoogle Scholar
  7. 7.
    Matheson DM, Keighley MR (1981) Manometric evaluation of rectal prolapse and faecal incontinence. Gut 22:126–129PubMedCrossRefGoogle Scholar
  8. 8.
    Glasgow SC, Birnbaum EH et al (2006) Preoperative anal manometry predicts continence after perineal proctectomy for rectal prolapse. Dis Colon Rectum 49:1052–1058PubMedCrossRefGoogle Scholar
  9. 9.
    Williams JG, Wong WD, Jensen L et al (1999) Incontinence and rectal prolapse: a prospective manometric study. Dis Colon Rectum 34:209–216CrossRefGoogle Scholar
  10. 10.
    Delorme E (1985) On the treatment of total prolapse of the rectum by excision of the rectal mucous membranes or rectocolic. Dis Colon Rectum 28:544–553CrossRefGoogle Scholar
  11. 11.
    Altemeier WA, Culbertson WR, Schowengerdt C, Hunt J (1971) Nineteen years’ experience with the one-stage perineal repair of rectal prolapse. Ann Sur 173:993–1006CrossRefGoogle Scholar
  12. 12.
    Tsunoda A, Yasuda N, Yokoyama N et al (2003) Delorme’s procedure for rectal prolapse: clinical and physiological analysis. Dis Colon Rectum 46:1260–1265PubMedCrossRefGoogle Scholar
  13. 13.
    Senapati A, Nicholls RJ, Thompson JP, Phillips RK (1994) Results of Delorme’s procedure for rectal prolapse. Dis Colon Rectum 37:456–460PubMedCrossRefGoogle Scholar
  14. 14.
    Raftopoulos Y, Senagore AJ, Di Giuro G et al (2005) Recurrence rates after abdominal surgery for complete rectal prolapse: a multicenter pooled analysis of 643 individual patient data. Dis Colon Rectum 48: 1200–1206PubMedCrossRefGoogle Scholar
  15. 15.
    Marchal F, Bresler L, Ayav A et al (2005) Long-term results of Delorme’s procedure and Orr-Loygue rectopexy to treat complete rectal prolapse. Dis Colon Rectum 48:1785–1790PubMedCrossRefGoogle Scholar
  16. 16.
    Kim DS, Tsang CB, Wong WD et al (1999) Complete Rectal Prolapse: Evolution of Management and Results. Dis Colon Rectum 42:460–469PubMedCrossRefGoogle Scholar
  17. 17.
    Agachan F, Reissman P, Pfeifer J et al (1997) Comparison of three perineal procedures for the treatment of rectal prolapse. South Med J 90:925–932PubMedGoogle Scholar
  18. 18.
    Prasad Ml, Pearl RK, Abcarian H et al (1986) Perineal proctectomy, posterior rectopexy, and postanal levator repair for the treatment of rectal prolapse. Diseases of the Colon and Rectum 29:547–552PubMedCrossRefGoogle Scholar
  19. 19.
    Pescatori M, Interisano A et al (1998) Delorme’s operation and sphincteroplasty for rectal prolapse and fecal incontinence. Int J Colorect Dis 13:223–227CrossRefGoogle Scholar
  20. 20.
    Bachoo P, Brazelli M, Grant A (2000) Surgery for complete rectal prolapse in adults. Cochrane Database Syst Rev CD001758Google Scholar

Copyright information

© Springer-Verlag Italia 2008

Authors and Affiliations

  • Steven D. Wexner
    • 1
    • 2
  • Amit Khanna
    • 3
  1. 1.Department of Colorectal SurgeryOhio State UniversityUSA
  2. 2.Department of Surgery, University of South Florida College of MedicineCleveland Clinic FloridaWestonUSA
  3. 3.Department of Colorectal SurgeryCleveland Clinic FloridaWestonUSA

Personalised recommendations