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Published in: Diseases of the Colon & Rectum 11/2008

01-11-2008 | Technical Notes

Perineal Stapled Prolapse Resection: A New Procedure for External Rectal Prolapse

Authors: Roland Scherer, M.D., Lukas Marti, M.D., Franc H. Hetzer, M.D.

Published in: Diseases of the Colon & Rectum | Issue 11/2008

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Abstract

Purpose

A perineal approach to treating rectal prolapse is ideal for frail patients. Recently, internal rectal redundancy has been successfully treated with transanal resection using the Contour® Transtar™ stapler. This technique has been modified to the perineal stapled prolapse resection. The surgical technique and the preliminary results of the new procedure for external rectal prolapse are presented.

Methods

Patients not suited for transabdominal treatment were included prospectively for perineal stapled prolapse resection in two colorectal centers. Feasibility, complications, and reinterventions were assessed.

Results

In 14 of 15 patients, perineal stapled prolapse resection was performed without complications in a median operating time of 33 (range, 22–52) minutes. One procedure was changed to an Altemeier because of a staple line disruption. Two patients required reintervention as a result of postoperative hemorrhage. No other severe complications occurred. At follow-up, all patients were well and showed no early recurrence of prolapse.

Conclusions

Perineal stapled prolapse resection is a new surgical procedure for external rectal prolapse, which is easy and quick to perform. Functional results and long-term recurrence rate must be investigated further.
Literature
2.
3.
go back to reference Renzi A, Izzo D, Di Sarno G, Izzo G, Di Martino N. Stapled transanal rectal resection to treat obstructed defecation caused by rectal intussusception and rectocele. Int J Colorectal Dis 2006;21:661–7.PubMedCrossRef Renzi A, Izzo D, Di Sarno G, Izzo G, Di Martino N. Stapled transanal rectal resection to treat obstructed defecation caused by rectal intussusception and rectocele. Int J Colorectal Dis 2006;21:661–7.PubMedCrossRef
4.
go back to reference Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2004;240:205–13.PubMedCrossRef Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2004;240:205–13.PubMedCrossRef
5.
go back to reference Agachan F, Reissman P, Pfeifer J, Weiss EG, Nogueras JJ, Wexner SD. Comparison of three perineal procedures for the treatment of rectal prolapse. South Med J 1997;90:925–32.PubMed Agachan F, Reissman P, Pfeifer J, Weiss EG, Nogueras JJ, Wexner SD. Comparison of three perineal procedures for the treatment of rectal prolapse. South Med J 1997;90:925–32.PubMed
6.
go back to reference Altemeier WA, Culbertson WR, Schowengerdt C, Hunt J. Nineteen years' experience with the one-stage perineal repair of rectal prolapse. Ann Surg 1971;173:993–1006.PubMedCrossRef Altemeier WA, Culbertson WR, Schowengerdt C, Hunt J. Nineteen years' experience with the one-stage perineal repair of rectal prolapse. Ann Surg 1971;173:993–1006.PubMedCrossRef
7.
go back to reference Watkins BP, Landercasper J, Belzer GE, et al. Long-term follow-up of the modified Delorme procedure for rectal prolapse. Arch Surg 2003;138:498–503.PubMedCrossRef Watkins BP, Landercasper J, Belzer GE, et al. Long-term follow-up of the modified Delorme procedure for rectal prolapse. Arch Surg 2003;138:498–503.PubMedCrossRef
8.
go back to reference Boccasanta P, Venturi M, Barbieri S, Roviaro G. Impact of new technologies on the clinical and functional outcome of Altemeier's procedure: a randomized, controlled trial. Dis Colon Rectum 2006;49:652–60.PubMedCrossRef Boccasanta P, Venturi M, Barbieri S, Roviaro G. Impact of new technologies on the clinical and functional outcome of Altemeier's procedure: a randomized, controlled trial. Dis Colon Rectum 2006;49:652–60.PubMedCrossRef
9.
go back to reference Hetzer F, Schmid RA, Inderbizin D, Schob O. Laparoscopic sigmoid resection: a comparative experimental study between double-stapling and foreign material free-biostent technique (TESA). Transient endoluminally stented anastomosis. J Laparoendosc Adv Surg Tech A 1998;8:285–93.PubMedCrossRef Hetzer F, Schmid RA, Inderbizin D, Schob O. Laparoscopic sigmoid resection: a comparative experimental study between double-stapling and foreign material free-biostent technique (TESA). Transient endoluminally stented anastomosis. J Laparoendosc Adv Surg Tech A 1998;8:285–93.PubMedCrossRef
Metadata
Title
Perineal Stapled Prolapse Resection: A New Procedure for External Rectal Prolapse
Authors
Roland Scherer, M.D.
Lukas Marti, M.D.
Franc H. Hetzer, M.D.
Publication date
01-11-2008
Publisher
Springer-Verlag
Published in
Diseases of the Colon & Rectum / Issue 11/2008
Print ISSN: 0012-3706
Electronic ISSN: 1530-0358
DOI
https://doi.org/10.1007/s10350-008-9423-0

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