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Per anal endoscopic rectopexy for treatment of complete rectal prolapse: A preliminary report

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Abstract

We describe Per Anal Endoscopic Rectopexy (PAER), a new treatment for complete rectal prolapse, which involves fixing the anterior rectal wall to the under-surface of the anterior abdominal wall and posterior rectal wall to the sacrum, through a submucosal tunnel (both endoluminally). This is a prospective single-centre pilot study done at a tertiary care centre. A total of 12 patients with a mean age of 48 years underwent the procedure. Constipation and incontinence were present in 8 and 4 patients, respectively and a significant improvement was seen in both following the procedure. A significant decrease in anorectal angle and its descent was also observed on post procedure magnetic resonance defecography. One patient had partial recurrence of prolapse. No major morbidity was observed. PAER is a minimally invasive and safe option for rectal prolapse, which needs to be validated in more patients over a longer follow up period.

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References

  1. D’Hoore A, Cadoni R, Penninckx F. Long-term outcome of laparoscopic ventral rectopexy for total rectal prolapse. Br J Surg. 2004;91:1500–5.

    Article  Google Scholar 

  2. Formijne Jonkers HA, Poierrié N, Draaisma WA, Broeders IA, Consten EC. Laparoscopic ventral rectopexy for rectal prolapse and symptomatic rectocele: an analysis of 245 consecutive patients. Colorectal Dis. 2013;15:695–9.

  3. Bloemendaal AL, De Schepper M, Mishra A, et al. Trans-anal endoscopic microsurgery for internal rectal prolapse. Tech Coloproctol. 2016;20:129–33.

    Article  CAS  Google Scholar 

  4. Milsom J, Trencheva K, Pavoor R, et al. Endoscopic fixation of the rectum for rectal prolapse: a feasibility and survival experimental study. Surg Endosc. 2011;25:3691–7.

  5. Bustamante-Lopez L, Sulbaran M, Sakai C, et al. A novel technique for correction of total rectal prolapse: endoscopic-assisted percutaneous rectopexy with the aid of the EndoLifter. Rev Gastroenterol Mex. 2016;81:202–7.

    CAS  PubMed  Google Scholar 

  6. Vaizey CJ, Carapeti E, Cahill JA, Kamm MA. Prospective comparison of faecal incontinence grading systems. Gut. 1999;44:77–80.

    Article  CAS  Google Scholar 

  7. Renzi A, Brillantino A, Di Sarno G, d'Aniello F. Five-item score for obstructed defecation syndrome: study of validation. Surg Innov. 2013;20:119–25.

    Article  Google Scholar 

  8. Saxena S, Chandiramani K, Bhargava R. WHOQOL-Hindi: a questionnaire for assessing quality of life in health care settings in India–World Health Organization quality of life. Natl Med J India. 1998;11:160–5.

  9. Chandra A, Kumar S, Maurya AP, Gupta V, Gupta V, Rahul. Laparoscopic ventral mesh rectopexy for complete rectal prolapse: A retrospective study evaluating outcomes in north Indian population. World J Gastrointest Surg. 2016;8:321–5.

  10. Chandra A, Mishra B, Kumar S, et al. Composite Antropyloric valve and gluteus Maximus muscle wrap for neo-anal reconstruction: Initial results. Dis Colon Rectum. 2019;62:104–11.

  11. Pemberton J, Stalker LK. Surgical treatment of complete rectal prolapse. Ann Surg. 1939;109:799–808.

  12. Kalloo AN, Singh VK, Jagannath SB, et al. Flexible transgastric -peritoneoscopy: a novel approach to diagnostic and therapeutic interventions. Gastrointest Endosc. 2004. 60:114–7.

  13. Pasricha PJ, Hawari R, Ahmed I, et al. Submucosal endoscopic esophageal myotomy: novel experimental approach for the treatment of achalasia. Endoscopy. 2007;39:761–4.

    Article  CAS  Google Scholar 

  14. Inoue H, Minami H, Kobayashi Y, et al. Peroral endoscopic myotomy (POEM) for esophageal achalasia. Endoscopy. 2010;42:265–71.

    Article  CAS  Google Scholar 

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Surgical Gastroenterology, King George’s Medical University, Lucknow, 226 003, India

    Abhijit Chandra, Saket Kumar, Pritheesh Rajan, Nitin Kumar, Pavan Kumar, Amit Dangi & Pradeep Joshi

  2. Department of Gastroenterology, Hepatology and Motility, The University of Kansas Medical Center, 901 Rainbow Boulevard, Kansas City, KS, 66160, USA

    Amit Rastogi

Authors
  1. Abhijit Chandra
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  2. Saket Kumar
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  3. Amit Rastogi
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  4. Pritheesh Rajan
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  5. Nitin Kumar
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  6. Pavan Kumar
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  7. Amit Dangi
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  8. Pradeep Joshi
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Corresponding author

Correspondence to Abhijit Chandra.

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Conflict of interest

AC, SK, AR, PR, NK, PK, AD, and PJ declare that they have no conflict of interest.

Ethics statement

The study was performed conforming to the Helsinki declaration of 1975, as revised in 2000 and 2008 concerning human and animal rights, and the authors followed the policy concerning informed consent as shown on Springer.com.

Ethical approval

The ethical approval to perform the PAER procedure was obtained from the ethics committee of King George’s Medical University, Lucknow, India (Ref. Code: 90th ECM II A/P20; dated 02/07/18).

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Chandra, A., Kumar, S., Rastogi, A. et al. Per anal endoscopic rectopexy for treatment of complete rectal prolapse: A preliminary report. Indian J Gastroenterol 38, 542–549 (2019). https://doi.org/10.1007/s12664-019-00999-8

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  • DOI: https://doi.org/10.1007/s12664-019-00999-8

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