Perineal stapled prolapse resection for external rectal prolapse: is it worthwhile in the long-term?

Tech Coloproctol. 2013 Oct;17(5):537-40. doi: 10.1007/s10151-013-1009-8. Epub 2013 Apr 24.

Abstract

Background: Perineal stapled prolapse (PSP) resection is a novel operation for treating external rectal prolapse. However, no long-term results have been reported in the literature. This study analyses the long-term recurrence rate, functional outcome, and morbidity associated with PSP resection.

Methods: Nine consecutive patients undergoing PSP resection between 2007 and 2011 were prospectively followed. Surgery was performed by the same surgeons in a standardised technique. Recurrence rate, functional outcome, and complication grade were prospectively assessed.

Results: All 9 patients undergoing PSP resection were investigated. The median age was 72 years (range 25-88 years). No intraoperative complications occurred. Faecal incontinence, preoperatively present in 2 patients, worsened postoperatively in one patient (Vaizey 18-22). One patient developed new-onset faecal incontinence (Vaizey 18). The median obstructive defecation syndrome score decreased postoperatively significantly from 11 (median; range 8-13) to 5 (median; range 4-8) (p < 0.005). At a median follow-up of 40 months (range 14-58 months), the prolapse recurrence rate was 44 % (4/9 patients).

Conclusions: The PSP resection is a fast and safe procedure associated with low morbidity. However, the poor long-term functional outcome and the recurrence rate of 44 % warrant a cautious patient selection.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Fecal Incontinence / etiology
  • Fecal Incontinence / prevention & control*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods
  • Patient Safety
  • Perineum / surgery
  • Proctoscopy / methods*
  • Prospective Studies
  • Rectal Prolapse / complications
  • Rectal Prolapse / diagnosis
  • Rectal Prolapse / surgery*
  • Rectum / surgery*
  • Recurrence
  • Reoperation
  • Risk Assessment
  • Severity of Illness Index
  • Surgical Stapling / methods*
  • Time Factors
  • Treatment Outcome