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Published in: Journal of Medical Case Reports 1/2009

Open Access 01-12-2009 | Case report

Altemeier operation associated with dynamic graciloplasty: a case report

Authors: Massimo Mongardini, Roberto Paolo Iachetta, Alessandra Cola, Eleonora Degli Effetti, Filippo Custureri

Published in: Journal of Medical Case Reports | Issue 1/2009

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Abstract

Introduction

More than 80% of patients with full-thickness rectal prolapse have co-existing fecal incontinence. Choosing the ideal surgical strategy is always a difficult task. We combined an Altemeier rectosigmoid resection with anal dynamic graciloplasty to provide a functional neosphincter. We found no published reports describing this surgical association.

Case presentation

We report the case of a 72-year-old Caucasian woman with full-thickness rectal prolapse associated with fecal incontinence from severe neuromuscular damage.

Conclusion

Combined dynamic graciloplasty and an Altemeier operation could be a valid therapeutic option in patients with severe rectal prolapse with fecal incontinence from severe neurogenic damage.
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Literature
1.
go back to reference Woods R, Voyvodic F, Schloithe C, Sage MR, Wattchow A: Anal sphincter tears in patients with rectal prolapse and faecal incontinence. Colorectal Dis. 2003, 5: 544-548. 10.1046/j.1463-1318.2003.00469.x.CrossRefPubMed Woods R, Voyvodic F, Schloithe C, Sage MR, Wattchow A: Anal sphincter tears in patients with rectal prolapse and faecal incontinence. Colorectal Dis. 2003, 5: 544-548. 10.1046/j.1463-1318.2003.00469.x.CrossRefPubMed
2.
go back to reference Chapman AE, Geerdes B, Hewett P, Young J, Eyers T, Kiroff G, Maddern GJ: Systematic review of dynamic graciloplasty in the treatment of faecal incontinence. Br J Surg. 2002, 89: 138-153.CrossRefPubMed Chapman AE, Geerdes B, Hewett P, Young J, Eyers T, Kiroff G, Maddern GJ: Systematic review of dynamic graciloplasty in the treatment of faecal incontinence. Br J Surg. 2002, 89: 138-153.CrossRefPubMed
3.
go back to reference Zbar AP, Takashima S, Hasegawa T, Kitabayashi K: Perineal rectosigmoidectomy (Altemeier's procedure): a review of physiology, technique and outcome. Tech Coloproctol. 2002, 6: 109-116. 10.1007/s101510200024.CrossRefPubMed Zbar AP, Takashima S, Hasegawa T, Kitabayashi K: Perineal rectosigmoidectomy (Altemeier's procedure): a review of physiology, technique and outcome. Tech Coloproctol. 2002, 6: 109-116. 10.1007/s101510200024.CrossRefPubMed
4.
go back to reference Kim DS, Tsang CB, Wong WD, Lowry AC, Goldberg SM, Madoff RD: Complete rectal prolapse: evolution of management and results. Dis Colon Rectum. 1999, 42: 460-469. 10.1007/BF02234167.CrossRefPubMed Kim DS, Tsang CB, Wong WD, Lowry AC, Goldberg SM, Madoff RD: Complete rectal prolapse: evolution of management and results. Dis Colon Rectum. 1999, 42: 460-469. 10.1007/BF02234167.CrossRefPubMed
5.
go back to reference Kimmis MH, Evetts BK, Isler J, Billingham R: The Altemeier repair: outpatient treatment of rectal prolapse. Dis Colon Rectum. 2001, 44: 565-570. 10.1007/BF02234330.CrossRef Kimmis MH, Evetts BK, Isler J, Billingham R: The Altemeier repair: outpatient treatment of rectal prolapse. Dis Colon Rectum. 2001, 44: 565-570. 10.1007/BF02234330.CrossRef
6.
go back to reference Prasad ML, Pearl RK, Abcarian H, Orsay CP, Nelson RL: Perineal proctectomy, posterior rectopexy and postanal levator repair for the treatment of rectal prolapse. Dis Colon Rectum. 1986, 29: 547-552. 10.1007/BF02554250.CrossRefPubMed Prasad ML, Pearl RK, Abcarian H, Orsay CP, Nelson RL: Perineal proctectomy, posterior rectopexy and postanal levator repair for the treatment of rectal prolapse. Dis Colon Rectum. 1986, 29: 547-552. 10.1007/BF02554250.CrossRefPubMed
7.
go back to reference Ramanujam P, Venkatesh K: Perineal excision of rectal prolapse with posterior levator ani repair in elderly high-risk patient. Dis Colon Rectum. 1988, 31: 704-706. 10.1007/BF02552589.CrossRefPubMed Ramanujam P, Venkatesh K: Perineal excision of rectal prolapse with posterior levator ani repair in elderly high-risk patient. Dis Colon Rectum. 1988, 31: 704-706. 10.1007/BF02552589.CrossRefPubMed
8.
go back to reference Pickrell KL, Broadbent TR, Masters FW, Metzger JT: Construction of a rectal sphincter and restoration of anal continence by transplanting the gracilis muscle. A report of 4 cases in children. Ann Surg. 1952, 135: 853-862. 10.1097/00000658-195206000-00010.CrossRefPubMedPubMedCentral Pickrell KL, Broadbent TR, Masters FW, Metzger JT: Construction of a rectal sphincter and restoration of anal continence by transplanting the gracilis muscle. A report of 4 cases in children. Ann Surg. 1952, 135: 853-862. 10.1097/00000658-195206000-00010.CrossRefPubMedPubMedCentral
9.
go back to reference Beaten CGMI, Konsten J, Spaans F, Visser R, Habets AM, Bourgeois IM, Wagenmakers AJ, Soeters PB: Dynamic graciloplasty for treatment of faecal incontinence. Lancet. 1991, 338: 1163-1165. 10.1016/0140-6736(91)92030-6.CrossRef Beaten CGMI, Konsten J, Spaans F, Visser R, Habets AM, Bourgeois IM, Wagenmakers AJ, Soeters PB: Dynamic graciloplasty for treatment of faecal incontinence. Lancet. 1991, 338: 1163-1165. 10.1016/0140-6736(91)92030-6.CrossRef
10.
go back to reference Williams NS, Patel J, George BD, Hallan RI, Watkins ES: Development of an electrically stimulated neoanal sphincter. Lancet. 1991, 338: 1166-1169. 10.1016/0140-6736(91)92031-V.CrossRefPubMed Williams NS, Patel J, George BD, Hallan RI, Watkins ES: Development of an electrically stimulated neoanal sphincter. Lancet. 1991, 338: 1166-1169. 10.1016/0140-6736(91)92031-V.CrossRefPubMed
11.
go back to reference George BD, Williams NS, Patel J, Swash M, Watkins ES: Physiological and histochemical adaptation of the electrically stimulated gracilis muscle to neoanal sphincter function. Br J Surg. 1993, 80: 1342-1346. 10.1002/bjs.1800801042.CrossRefPubMed George BD, Williams NS, Patel J, Swash M, Watkins ES: Physiological and histochemical adaptation of the electrically stimulated gracilis muscle to neoanal sphincter function. Br J Surg. 1993, 80: 1342-1346. 10.1002/bjs.1800801042.CrossRefPubMed
12.
go back to reference Cavina E, Seccia M, Banti P, Zocco G: Anorectal reconstruction after abdominoperineal resection. Experience with double-wrap graciloplasty supported by low-frequency electrostimulation. Dis Colon Rectum. 1998, 41: 1010-1016. 10.1007/BF02237392.CrossRefPubMed Cavina E, Seccia M, Banti P, Zocco G: Anorectal reconstruction after abdominoperineal resection. Experience with double-wrap graciloplasty supported by low-frequency electrostimulation. Dis Colon Rectum. 1998, 41: 1010-1016. 10.1007/BF02237392.CrossRefPubMed
13.
go back to reference Beaten CG, Bailey HR, Bakka A, Belliveau P, Berg E, Buie WD, Burnstein MJ, Christiansen J, Coller JA, Galandiuk S, LaFontaine LJ, Lange J, Madoff RD, Matzel KE, Påhlman L, Parc R, Reilly JC, Seccia M, Thorson AG, Vernava AM, Wexner S: Safety and efficacy of dynamic graciloplasty for faecal incontinence: report of a prospective, multicenter trial. Dynamic Graciloplasty Therapy Study Group. Dis Colon Rectum. 2000, 43: 743-751. 10.1007/BF02238008.CrossRef Beaten CG, Bailey HR, Bakka A, Belliveau P, Berg E, Buie WD, Burnstein MJ, Christiansen J, Coller JA, Galandiuk S, LaFontaine LJ, Lange J, Madoff RD, Matzel KE, Påhlman L, Parc R, Reilly JC, Seccia M, Thorson AG, Vernava AM, Wexner S: Safety and efficacy of dynamic graciloplasty for faecal incontinence: report of a prospective, multicenter trial. Dynamic Graciloplasty Therapy Study Group. Dis Colon Rectum. 2000, 43: 743-751. 10.1007/BF02238008.CrossRef
14.
go back to reference Devesa JM, Rey A, Hervas PL, Halawa KS, Larranaga I, Svidler L, Abraira V, Muriel A: Artificial anal sphincter: complication and functional results of a large personal series. Dis Colon Rectum. 2002, 45: 1154-1163. 10.1007/s10350-004-6382-y.CrossRefPubMed Devesa JM, Rey A, Hervas PL, Halawa KS, Larranaga I, Svidler L, Abraira V, Muriel A: Artificial anal sphincter: complication and functional results of a large personal series. Dis Colon Rectum. 2002, 45: 1154-1163. 10.1007/s10350-004-6382-y.CrossRefPubMed
15.
go back to reference Jarret MED, Matzel KE, Stosser M, Beaten CGM, Kamm MA: Sacral nerve stimulation for fecal incontinence following surgery for rectal prolapse repair: a multicenter study. Dis Colon Rectum. 2005, 48: 1243-1248. 10.1007/s10350-004-0919-y.CrossRef Jarret MED, Matzel KE, Stosser M, Beaten CGM, Kamm MA: Sacral nerve stimulation for fecal incontinence following surgery for rectal prolapse repair: a multicenter study. Dis Colon Rectum. 2005, 48: 1243-1248. 10.1007/s10350-004-0919-y.CrossRef
Metadata
Title
Altemeier operation associated with dynamic graciloplasty: a case report
Authors
Massimo Mongardini
Roberto Paolo Iachetta
Alessandra Cola
Eleonora Degli Effetti
Filippo Custureri
Publication date
01-12-2009
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2009
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/1752-1947-3-9317

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