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

Tschuor, C. ; Limani, P. ; Nocito, A. ; Dindo, D. ; Clavien, P. ; Hahnloser, D.

In: Techniques in Coloproctology, 2013, vol. 17, no. 5, p. 537-540

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    Titre
    • Perineal stapled prolapse resection for external rectal prolapse: is it worthwhile in the long-term?
    Auteur
    • Tschuor, C.. Clinic for Visceral and Transplantation Surgery, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
    • Limani, P.. Clinic for Visceral and Transplantation Surgery, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
    • Nocito, A.. Clinic for Visceral and Transplantation Surgery, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
    • Dindo, D.. Clinic for Visceral and Transplantation Surgery, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
    • Clavien, P.. Clinic for Visceral and Transplantation Surgery, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
    • Hahnloser, D.. Clinic for Visceral and Transplantation Surgery, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Techniques in Coloproctology, 2013, vol. 17, no. 5, p. 537-540. Springer Milan
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:311786
    Summary
    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 72years (range 25-88years). 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 40months (range 14-58months), 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