Diseases of the colon and rectum · 2018
Perineal Stapled Rectal Prolapse Resection in Elderly Patients: Long-term Follow-up.
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Ram Edward, Hoffman Aviad, Goldes Yuri, Rosin Danny, Horesh Nir, Gutman Mordechai, Edden Yair
Аннотация
BACKGROUND: Full-thickness rectal prolapse has a significant negative impact on quality of life. The therapeutic options, specifically in elderly patients, are imperfect. Perineal stapled rectal prolapse resection is a novel operation for treating external rectal prolapse. Long-term follow-up following this procedure is lacking. In our study, we report a long-term follow-up of 30 patients, analyzing the long-term recurrence rate, morbidity, and functional outcome.
OBJECTIVE: This study aimed to examine the long-term results of perineal stapled rectal resection in a population unfit for prolonged general anesthesia.
DESIGN: This was a cohort study with a prospective follow-up.
SETTINGS: This study was conducted at a single tertiary referral center.
PATIENTS: Patients undergoing perineal stapled rectal resection from January 2010 to June 2013 were included.
INTERVENTIONS: Perineal stapled rectal prolapse resection was performed.
MAIN OUTCOME MEASURES: The primary outcome measured was prolapse recurrence.
RESULTS: A total of 30 patients underwent the surgical intervention. The median follow-up period was 61 months (range, 37-65). No intraoperative or postoperative complications occurred. Six patients (20%) had recurrent rectal prolapse, and continence was not achieved in any of the patients. Two patients who had recurrence underwent a redo perineal stapled rectal resection.
LIMITATIONS: This study was limited by the small cohort of selected patients.
CONCLUSIONS: Frail patients that can only endure a short procedure under regional anesthesia should be considered for perineal stapled rectal prolapse resection. The lack of mortality and morbidity, specifically in this population, along with the low long-term recurrence rates, make this a favorable surgical alternative. See Video Abstract at http://links.lww.com/DCR/A745.
OBJECTIVE: This study aimed to examine the long-term results of perineal stapled rectal resection in a population unfit for prolonged general anesthesia.
DESIGN: This was a cohort study with a prospective follow-up.
SETTINGS: This study was conducted at a single tertiary referral center.
PATIENTS: Patients undergoing perineal stapled rectal resection from January 2010 to June 2013 were included.
INTERVENTIONS: Perineal stapled rectal prolapse resection was performed.
MAIN OUTCOME MEASURES: The primary outcome measured was prolapse recurrence.
RESULTS: A total of 30 patients underwent the surgical intervention. The median follow-up period was 61 months (range, 37-65). No intraoperative or postoperative complications occurred. Six patients (20%) had recurrent rectal prolapse, and continence was not achieved in any of the patients. Two patients who had recurrence underwent a redo perineal stapled rectal resection.
LIMITATIONS: This study was limited by the small cohort of selected patients.
CONCLUSIONS: Frail patients that can only endure a short procedure under regional anesthesia should be considered for perineal stapled rectal prolapse resection. The lack of mortality and morbidity, specifically in this population, along with the low long-term recurrence rates, make this a favorable surgical alternative. See Video Abstract at http://links.lww.com/DCR/A745.