2004, Number 4
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Med Sur 2004; 11 (4)
Treatment of complete rectal prolapse perineal5 rectosigmoidectomy
Correa RJM, Bahena-Aponte JA, Moreno CA
Language: Spanish
References: 32
Page: 227-234
PDF size: 721.42 Kb.
ABSTRACT
Rectal prolapse typically occurs in elderly patients, who are often poor surgical candidates
because of the presence of multiple comorbidities. Abdominal approaches to procidentia have low
recurrence rates but are associated with higher rates of morbidity and mortality. Perineal
rectosigmoidectomy (Altemeier repair) is a safe and effective approach to the treatment of
rectal prolapse and can be done as an outpatient procedure. In this article, the results of a
series of 19 consecutive Altemeier repairs are presented.
Objective: The objective was to analyze
our results, complications, mortality, and recurrence in a Colorectal Surgery Service for surgical
treatment of complete rectal prolapse.
Methods: Between 1995 and february 2000, 19 patients underwent
Altemeier repair of rectal prolapse. The mean patient age was 71.4 years. Preoperative, intraoperative,
and postoperative data were collected and analyzed for all patients.
Results: 19 patients; 18 were
female and 1 male with age range of 32 to 84 years. Evolution time was 1 to 48 months; 14 patients
had preoperative incontinence. Complications occurred in 15.3 percent of patients. All 19 patients
had complete objective resolution of prolapse.
Conclusions: Altemeier repair of rectal prolapse
is safe, produces minimal discomfort. It is ideally suited to be done on an outpatient basis, as
was done in the majority of patients in our series. The recurrence rate is slightly higher than with
abdominal resections, but morbidity is lower, and repeat perineal resections are easily and safely
performed.
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