Surgical Management of Complete Rectal Prolapse
摘要
Purpose. To review our experience in the surgical management of complete rectal prolapse. Methods. Medical records of 40 patients (16 males, 24 females; mean age 59.6 20.7 years; range 17-86 years) who received surgical treatment of complete rectal prolapse from January 1997 to December 2006 were reviewed retrospectively. Results. Patients in the abdominal group (n=28) underwent recto-went laparoscopic with or without rectopexy, of which eight patients underwent laparoscopic surgery. No postoperative mortality occurred. Major perioperative complications included one anastomotic leakage in both the abdominal group and the perineal group (n=12). Recurrence rates were 2 of 28 (7.2%) in the abdominal group and 4 of 12 (33.3%) in the perineal group; p=0.034. Only 2 of the latter 4 patients received surgical treatment for the recurrent rectal prolapse (one abdominal procedure and one repeated perineal procedure). The latter patient experienced internal bleeding and was converted to laparotomy. Conclusions. An abdominal procedure can have a significantly lower recurrence rate than the perineal procedure, and so is recommended for younger and healthier patients. The perineal procedure, which has a higher recurrence rate but lower surgical risk, is more suitable for elderly patients or those with higher operative risk.