Rectal prolapse surgery: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Rectal prolapse}} | {{Rectal prolapse}} | ||
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==Overview== | ==Overview== | ||
Rectal prolapse surgery has two different approaches: Abdominal surgery (lower recurrence rate and better functional outcomes) or perineal surgery (in elderly patients, significant [[Comorbidity|comorbidities]], high risk patients for [[General anaesthesia|general anesthesia]], previous pelvic surgery or [[Radiation therapy|radiation]]). | |||
==Surgery== | ==Surgery== | ||
Surgical management is indicated when conservative managements have failed.<ref name="pmid20238206">{{cite journal |vauthors=Flum AS, Golladay ES, Teitelbaum DH |title=Recurrent rectal prolapse following primary surgical treatment |journal=Pediatr. Surg. Int. |volume=26 |issue=4 |pages=427–31 |year=2010 |pmid=20238206 |pmc=2862483 |doi=10.1007/s00383-010-2565-x |url=}}</ref><ref name="pmid29103788">{{cite journal |vauthors=Dolejs SC, Sheplock J, Vandewalle RJ, Landman MP, Rescorla FJ |title=Sclerotherapy for the management of rectal prolapse in children |journal=J. Pediatr. Surg. |volume= |issue= |pages= |year=2017 |pmid=29103788 |doi=10.1016/j.jpedsurg.2017.10.015 |url=}}</ref> | |||
=== '''Abdominal surgery:''' === | |||
Afford a lower recurrence rate with potentially better functional outcomes and below methods may be used:<ref name="pmid28991075">{{cite journal |vauthors=Vogler SA |title=Rectal Prolapse |journal=Dis. Colon Rectum |volume=60 |issue=11 |pages=1132–1135 |year=2017 |pmid=28991075 |doi=10.1097/DCR.0000000000000955 |url=}}</ref> | |||
*'''Ventral mesh rectopexy''' | |||
*'''Posterior suture rectopexy''' (with or without [[Sigmoid colon|sigmoid]] [[resection]]) | |||
*'''Posterior mesh rectopexy''' | |||
=== '''Perineal surgery:''' === | |||
Elderly patients, patients with significant [[Comorbidity|comorbidities]], patients who are high risk for [[General anaesthesia|general anesthesia]], previous extensive pelvic surgery or [[Radiation therapy|radiation]]<ref name="pmid24352613">{{cite journal |vauthors=Bordeianou L, Hicks CW, Kaiser AM, Alavi K, Sudan R, Wise PE |title=Rectal prolapse: an overview of clinical features, diagnosis, and patient-specific management strategies |journal=J. Gastrointest. Surg. |volume=18 |issue=5 |pages=1059–69 |year=2014 |pmid=24352613 |doi=10.1007/s11605-013-2427-7 |url=}}</ref><ref name="pmid21431090">{{cite journal |vauthors=Shin EJ |title=Surgical treatment of rectal prolapse |journal=J Korean Soc Coloproctol |volume=27 |issue=1 |pages=5–12 |year=2011 |pmid=21431090 |pmc=3053504 |doi=10.3393/jksc.2011.27.1.5 |url=}}</ref> | |||
*'''Thiersch procedure''': using a prothesis that narrows the [[anus]] | |||
*'''Delorme procedure''': peels off the herniated mucosa, plicates the exposed muscular layer, and [[Suture|sutures]] the anorectal mucosa | |||
*'''Altemeier procedure''' (perineal [[Sigmoid colon|sigmoid]] colorectal [[resection]]): the protruded rectum is resected 2cm above the dentate line and the [[mesentery]] of the [[sigmoid colon]] is pulled and ligated | |||
*'''Gant_Miwa procedure''': herniated [[Mucous membrane|mucosa]] is plicated by [[ligation]], muscle layer is sutured and the anal opening is narrowed by a prothesis (not widely accepted) | |||
{{#ev:youtube|KvfNsLIJefs}} | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
[[Category: | [[Category:Medicine]] | ||
[[Category:Gastroenterology]] | |||
[[Category:Surgery]] | |||
Latest revision as of 16:45, 28 February 2018
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Rectal prolapse surgery On the Web |
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Risk calculators and risk factors for Rectal prolapse surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Shaghayegh Habibi, M.D.[2]
Overview
Rectal prolapse surgery has two different approaches: Abdominal surgery (lower recurrence rate and better functional outcomes) or perineal surgery (in elderly patients, significant comorbidities, high risk patients for general anesthesia, previous pelvic surgery or radiation).
Surgery
Surgical management is indicated when conservative managements have failed.[1][2]
Abdominal surgery:
Afford a lower recurrence rate with potentially better functional outcomes and below methods may be used:[3]
- Ventral mesh rectopexy
- Posterior suture rectopexy (with or without sigmoid resection)
- Posterior mesh rectopexy
Perineal surgery:
Elderly patients, patients with significant comorbidities, patients who are high risk for general anesthesia, previous extensive pelvic surgery or radiation[4][5]
- Thiersch procedure: using a prothesis that narrows the anus
- Delorme procedure: peels off the herniated mucosa, plicates the exposed muscular layer, and sutures the anorectal mucosa
- Altemeier procedure (perineal sigmoid colorectal resection): the protruded rectum is resected 2cm above the dentate line and the mesentery of the sigmoid colon is pulled and ligated
- Gant_Miwa procedure: herniated mucosa is plicated by ligation, muscle layer is sutured and the anal opening is narrowed by a prothesis (not widely accepted)
{{#ev:youtube|KvfNsLIJefs}}
References
- ↑ Flum AS, Golladay ES, Teitelbaum DH (2010). "Recurrent rectal prolapse following primary surgical treatment". Pediatr. Surg. Int. 26 (4): 427–31. doi:10.1007/s00383-010-2565-x. PMC 2862483. PMID 20238206.
- ↑ Dolejs SC, Sheplock J, Vandewalle RJ, Landman MP, Rescorla FJ (2017). "Sclerotherapy for the management of rectal prolapse in children". J. Pediatr. Surg. doi:10.1016/j.jpedsurg.2017.10.015. PMID 29103788.
- ↑ Vogler SA (2017). "Rectal Prolapse". Dis. Colon Rectum. 60 (11): 1132–1135. doi:10.1097/DCR.0000000000000955. PMID 28991075.
- ↑ Bordeianou L, Hicks CW, Kaiser AM, Alavi K, Sudan R, Wise PE (2014). "Rectal prolapse: an overview of clinical features, diagnosis, and patient-specific management strategies". J. Gastrointest. Surg. 18 (5): 1059–69. doi:10.1007/s11605-013-2427-7. PMID 24352613.
- ↑ Shin EJ (2011). "Surgical treatment of rectal prolapse". J Korean Soc Coloproctol. 27 (1): 5–12. doi:10.3393/jksc.2011.27.1.5. PMC 3053504. PMID 21431090.