Perineal Stapled Rectal Prolapse Resection in Elderly Patients: Long-term Follow-up

Dis Colon Rectum. 2018 Nov;61(11):1316-1319. doi: 10.1097/DCR.0000000000001215.

Abstract

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.

Publication types

  • Video-Audio Media

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Colectomy* / adverse effects
  • Colectomy* / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Israel / epidemiology
  • Long Term Adverse Effects* / diagnosis
  • Long Term Adverse Effects* / psychology
  • Male
  • Perineum / surgery
  • Postoperative Complications* / diagnosis
  • Postoperative Complications* / psychology
  • Quality of Life*
  • Rectal Prolapse* / epidemiology
  • Rectal Prolapse* / psychology
  • Rectal Prolapse* / surgery
  • Recurrence
  • Surgical Stapling* / adverse effects
  • Surgical Stapling* / methods
  • Treatment Outcome