Ann Surg Treat Res.  2014 May;86(5):249-255. 10.4174/astr.2014.86.5.249.

Comparison of abdominal and perineal procedures for complete rectal prolapse: an analysis of 104 patients

• Lee JL
• Yang SS
• Park IJ
• Yu CS
• Kim JC

• KMID: 1889662
• DOI: http://doi.org/10.4174/astr.2014.86.5.249

Abstract

PURPOSE
Selecting the best surgical approach for treating complete rectal prolapse involves comparing the operative and functional outcomes of the procedures. The aims of this study were to evaluate and compare the operative and functional outcomes of abdominal and perineal surgical procedures for patients with complete rectal prolapse.
METHODS
A retrospective study of patients with complete rectal prolapse who had operations at a tertiary referral hospital and a university hospital between March 1990 and May 2011 was conducted. Patients were classified according to the type of operation: abdominal procedure (AP) (n = 64) or perineal procedure (PP) (n = 40). The operative outcomes and functional results were assessed.
RESULTS
The AP group had the younger and more men than the PP group. The AP group had longer operation times than the PP group (165 minutes vs. 70 minutes; P = 0.001) and longer hospital stays (10 days vs. 7 days; P = 0.001), but a lower overall recurrence rate (6.3% vs. 15.0%; P = 0.14). The overall rate of the major complication was similar in the both groups (10.9% vs. 6.8%; P = 0.47). The patients in the AP group complained more frequently of constipation than of incontinence, conversely, in the PP group of incontinence than of constipation.
CONCLUSION
The two approaches for treating complete rectal prolapse did not differ with regard to postoperative morbidity, but the overall recurrence tended to occur frequently among patients in the PP group. Functional results after each surgical approach need to be considered for the selection of procedure.

Keyword

Rectal prolapse; Abdomen; Perineum; Procedure

MeSH Terms

Abdomen
Constipation
Humans
Length of Stay
Male
Perineum
Rectal Prolapse*
Recurrence
Retrospective Studies
Tertiary Care Centers

Figure

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  Fig. 1 Pre- and postoperative manometric results in the abdominal (A) and perineal procedure (B) groups. The postoperative values were generally obtained between three and six months after the operation. For both groups, the mean maximal resting pressure (MRP) after the operation was higher than the preoperative MRP. The other manometric values did not changed significantly in either group. MSP, maximal squeezing pressure; MSV, minimal sensory volume; UV, urgent need to defecate volume; MTV, maximal tolerance volume; SL, sphincter length; HPZ, high-pressure zone.

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