Annals of Coloproctology

Display

Sort by :

Original Article

Anorectal physiology & pelvic floor disorder

Laparoscopic ventral mesh rectopexy with and without transverse perineal support using biological mesh for rectal prolapse and perineal descent: postoperative course and functional outcomes: Maria Clelia Gervasi, Giorgio Brancato, Lorenzo Crepaz, Ahmad Tfaily, Alberto Di Leo; Ann Coloproctol. 2025;41(5):453-461. Published online October 28, 2025; DOI: https://doi.org/10.3393/ac.2025.00080.0011

1,109 View
42 Download

Abstract PDF Supplementary Material: Purpose
Laparoscopic ventral mesh rectopexy (LVMR) is effective for the treatment of rectal prolapse. However, descending perineal syndrome may impair the outcomes of LVMR. The aim of this study was to assess the safety and functional outcomes of LVMR performed with and without transverse perineal support (TPS).
Methods
This was a retrospective study of 143 consecutive female patients treated with LVMR with or without TPS between 2018 and 2022. Patients with rectal prolapse and perineal descent who underwent surgery were included. Obstructed defecation syndrome and fecal incontinence were evaluated using the Cleveland Constipation Score (Wexner score) and St. Mark’s Incontinence Score, respectively. Perineal descent was defined using defecography. Biological meshes were utilized in all cases.
Results
No significant differences were recorded between with- and without-TPS groups at baseline. TPS was performed in 110 patients (76.9%). Surgical morbidity was higher in the with-TPS group (12.7% vs. 0%, P=0.047), primarily due to seroma formation. Almost all complications were mild (Clavien-Dindo grades I–II). In both groups, digital aid for defecation (P<0.001), prolonged straining (P=0.004), and hematochezia (P<0.001) nearly disappeared postoperatively, though constipation and laxative/enema use persisted in 22.4%. Fecal incontinence significantly decreased from 43.4% to 11.2% (P<0.001). TPS appears to have a potentially favorable effect in reducing the constipation score. Both constipation and incontinence scores remained low up to 24 months after surgery. Operative time was significantly longer in the LVMR with-TPS group (P<0.001).
Conclusion
LVMR with TPS appears safe and feasible. TPS may provide better surgical outcomes compared to LVMR alone for patients with symptomatic rectoceles and descending perineum syndrome.

Case Report

Colorectal cancer

Treatment of side limb full-thickness prolapse of the side-to-end coloanal anastomosis following intersphincteric resection: a case report and review of literature: Guglielmo Niccolò Piozzi, Krunal Khobragade, Seon Hui Shin, Jeong Min Choo, Seon Hahn Kim; Ann Coloproctol. 2024;40(Suppl 1):S38-S43. Published online February 8, 2023; DOI: https://doi.org/10.3393/ac.2022.00829.0118

4,137 View
109 Download
1 Citations

Abstract PDF

Intersphincteric resection (ISR) with coloanal anastomosis is an oncologically safe anus-preserving technique for very low-lying rectal cancers. Most studies focused on oncological and functional outcomes of ISR with very few evaluating long-term postoperative anorectal complications. Full-thickness prolapse of the neorectum is a relatively rare complication. This report presents the case of a 70-year-old woman presenting with full-thickness prolapse of the side limb of the side-to-end coloanal anastomosis occurring 2 weeks after the stoma closure and 2 months after a robotic partial ISR performed with the Da Vinci single-port platform. The anastomosis was revised through resection of the side limb and conversion of the side-to-end anastomosis into an end-to-end handsewn anastomosis with interrupted stitches. This study describes the first case of full-thickness prolapse of the side limb of the side-to-end handsewn coloanal anastomosis following ISR. Moreover, a revision of all reported cases of post-ISR full-thickness and mucosal prolapse was performed.

Citations

Citations to this article as recorded by

International standardization and optimization group for intersphincteric resection (ISOG‐ISR): modified Delphi consensus on anatomy, definition, indication, surgical technique, specimen description and functional outcome
Guglielmo Niccolò Piozzi, Krunal Khobragade, Vusal Aliyev, Oktar Asoglu, Paolo Pietro Bianchi, Vlad‐Olimpiu Butiurca, William Tzu‐Liang Chen, Ju Yong Cheong, Gyu‐Seog Choi, Andrea Coratti, Quentin Denost, Yosuke Fukunaga, Emre Gorgun, Francesco Guerra, Ma
Colorectal Disease.2023; 25(9): 1896. CrossRef

Original Articles

Anorectal physiology & pelvic floor disorder

Efficacy and safety of anal encirclement combining the Leeds-Keio artificial ligament with injection sclerotherapy using aluminum potassium sulfate and tannic acid in the management of rectal prolapse: a single-center observational study: Tatsuya Abe, Masao Kunimoto, Yoshikazu Hachiro, Kei Ohara, Mitsuhiro Inagaki; Ann Coloproctol. 2023;39(3):210-215. Published online November 12, 2021; DOI: https://doi.org/10.3393/ac.2021.00731.0104

6,623 View
152 Download
3 Web of Science
5 Citations

Abstract PDF

Purpose
Perineal procedures are an important surgical option for frail and high-risk patients with rectal prolapse. This study aimed to evaluate the efficacy and safety of combined therapy using injection sclerotherapy, with aluminum potassium sulfate and tannic acid (ALTA), and the Thiersch procedure, using the Leeds-Keio ligament (ALTA-Thiersch).
Methods
This study included 106 consecutive patients (mean age, 81.2 years) who underwent ALTA-Thiersch for rectal prolapse. The procedure was performed under caudal epidural anesthesia. ALTA was injected into the submucosa from the tip of the prolapsed rectum down to the dentate line, circumferentially, at 20 to 40 locations. The ligament tape was placed outside the external sphincter muscle and at an approximate depth of 2 cm into the middle anal canal.
Results
Of 106 patients, rectal prolapse was cured shortly after surgery in 105 patients. An additional tape was inserted in 1 patient who had persistent prolapse. Postoperative complications were observed in 27 patients (25.5%). Fecal impaction occurred in 12 patients; however, since it was temporary, no tape removal was required. Of the 12 cases in which the tape was infected or exposed, 11 required tape removal. There were 18 cases of recurrence at a mean follow-up of 22.1 months. Cumulative recurrence rates at 3 and 5 years were 21.3% and 38.6%, respectively.
Conclusion
ALTA-Thiersch is a simple and safe procedure for rectal prolapse, having reasonable outcomes. The use of the Leeds-Keio ligament for anal encircling can help compensate for the disadvantages of the Thiersch operation.

Citations

Citations to this article as recorded by

Outcomes of the Gant-Miwa-Thiersch Procedure Using the Leeds-Keio Mesh for Rectal Prolapse
Naoto Nishigori, Yoshiyuki Sasaki, Shinsaku Obara
Journal of the Anus, Rectum and Colon.2025; 9(2): 252. CrossRef
Gant-Miwa-Thiersch Procedure for Rectal Prolapse - Use of the Leeds-Keio Mesh
Naoto Nishigori, Yoshiyuki Sasaki, Shinsaku Obara
Nihon Daicho Komonbyo Gakkai Zasshi.2025; 78(10): 398. CrossRef
Tissue engineering and regenerative medicine approaches in colorectal surgery
Bigyan B. Mainali, James J. Yoo, Mitchell R. Ladd
Annals of Coloproctology.2024; 40(4): 336. CrossRef
Efficacy and Safety of a New Technique Combining Injection Sclerotherapy and External Hemorrhoidectomy for Prolapsed Hemorrhoids: A Single-center Observational Study
Tatsuya Abe, Masao Kunimoto, Yoshikazu Hachiro, Akane Ito, Kenji Watanabe, Shigenori Ota, Kei Ohara, Mitsuhiro Inagaki, Yusuke Saitoh, Masanori Murakami
Journal of the Anus, Rectum and Colon.2024; 8(4): 331. CrossRef
Simple Anal Reinforcement with Anal Encirclement Using an Artificial Ligament in Patients with fecal Incontinence: A Single-center Observational Study
Tatsuya Abe, Masao Kunimoto, Yoshikazu Hachiro, Shigenori Ota, Kei Ohara, Mitsuhiro Inagaki
Journal of the Anus, Rectum and Colon.2022; 6(3): 174. CrossRef

Benign diesease & IBD,Surgical technique

Transanal rectopexy for external rectal prolapse: Shantikumar Dhondiram Chivate, Meghana Vinay Chougule, Rahul Shantikumar Chivate, Palak Harshuk Thakrar; Ann Coloproctol. 2022;38(6):415-422. Published online October 21, 2021; DOI: https://doi.org/10.3393/ac.2021.00262.0037

7,642 View
201 Download
2 Web of Science
2 Citations

Abstract PDF

Purpose
The surgical management of patients with full-thickness rectal prolapse (FTRP) continues to remain a challenge in the laparoscopic era. This study retrospectively assesses a cohort of patients undergoing a transanal suture sacro rectopexy supported by sclerosant injection into the presacral space under ultrasound guidance.
Methods
Patients with FTRP underwent a sutured transrectal presacral fixation of 2/3 of the circumference of the rectum from the third sacral vertebra to the sacrococcygeal junction through a side-viewing operating proctoscope. The procedure was supplemented by ultrasound-guided injection into the retrorectal space of a 2 mL solution of sodium tetradecyl sulfate/polidocanol mixed with air. Patients were functionally assessed before and 6 months after surgery with the Agachan constipation score and the Pescatori incontinence score.
Results
There were 36 adult patients (26 males; the range of age, 23–92 years). The mean operative time was 27 minutes (range, 23–50 minutes) with no recorded perioperative morbidity. The median follow-up was 66 months (range, 48–84 months) with 1 (2.8%) recurrence presenting 18 months after surgery. There were 19 patients (52.8%) who presented with incontinence before surgery with 17 out of 19 (89.5%) reporting improvement in their Pescatori score (P<0.001). No patient had worsening incontinence and there were no de novo incontinence cases. Constipation scores improved in 23 out of 36 patients (63.9%) with a mean score reduction difference of 7.91 (P=0.001).
Conclusion
Transanal sutured sacral rectopexy with supplemental presacral sclerosant injection is safe and effective in the management of FTRP with sustained improvement in bowel function.

Citations

Citations to this article as recorded by

Systematic literature review and meta-analysis of surgical treatment of complete rectal prolapse in male patients
S. H. Emile, A. Wignakumar, N. Horesh, Z. Garoufalia, V. Strassmann, M. Boutros, S. D. Wexner
Techniques in Coloproctology.2024;[Epub] CrossRef
External rectal prolapse: more than meets the eye
M. Yiasemidou, C. Yates, E. Cooper, R. Goldacre, I. Lindsey
Techniques in Coloproctology.2023; 27(10): 783. CrossRef

Benign proctology,Complication,Biomarker & risk factor

Longer prolapsed rectum length increases recurrence risk after Delorme’s procedure: Taro Tanabe, Emi Yamaguchi, Takuya Nakada, Risa Nishio, Kinya Okamoto, Tetsuo Yamana; Ann Coloproctol. 2022;38(4):314-318. Published online July 13, 2021; DOI: https://doi.org/10.3393/ac.2020.01032.0147

7,031 View
170 Download
3 Web of Science
6 Citations

Abstract PDF

Purpose
Risk factors for recurrence of rectal prolapse after surgery remain unclear. Delorme’s procedure is often selected for relatively small-sized rectal prolapse, but there are few reports discussing the association between prolapsed rectum length and prolapse recurrence after Delorme’s procedure. We hypothesized that patients with longer rectal prolapses are at a higher risk of recurrence after Delorme’s procedure.
Methods
The study population comprised patients with rectal prolapse who underwent Delorme’s procedure between January 2014 and December 2019 at Tokyo Yamate Medical Center. We extracted data on patient age, sex, body mass index, previous history of anal surgery, previous history of surgery for rectal prolapse, and length of prolapse, to identify risk factors for prolapse recurrence.
Results
Altogether, 96 patients were eligible for analysis. The median length of the prolapsed rectum was 3.0 cm (range, 1.0–6.6 cm). Twenty-four patients (25.0%) experienced recurrence after Delorme’s procedure after a median of 7.5 months (interquartile range, 3.2–20.9 months). Multivariate analysis revealed that longer prolapsed rectum length increased the risk of recurrence after Delorme’s procedure (hazard ratio, 6.28; 95% confidence interval, 1.83–21.50; P<0.001).
Conclusion
The length of the prolapsed rectum should be measured before Delorme’s procedure for rectal prolapse, because length is associated with a risk of recurrence after the surgery.

Citations

Citations to this article as recorded by

Surgical approaches for complete rectal prolapse
Long Wu, Huan Wu, Song Mu, Xiao-Yun Li, Yun-Huan Zhen, Hai-Yang Li
World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef
Tratamiento quirúrgico del prolapso rectal completo del adulto
C. Korkmaz, G. Meurette
EMC - Técnicas Quirúrgicas - Aparato Digestivo.2024; 40(1): 1. CrossRef
Trattamento chirurgico del prolasso rettale completo dell’adulto
C. Korkmaz, G. Meurette
EMC - Tecniche Chirurgiche Addominale.2024; 30(1): 1. CrossRef
The Predictive Risk Factor of Postoperative Recurrence Following Altemeier's and Delorme's Procedures for Full-thickness Rectal Prolapse: An Analysis of 127 Japanese Patients in a Single Institution
Yasuyuki Miura, Kimihiko Funahashi, Akiharu Kurihara, Satoru Kagami, Takayuki Suzuki, Kimihiko Yoshida, Mitsunori Ushigome, Tomoaki Kaneko
Journal of the Anus, Rectum and Colon.2024; 8(3): 171. CrossRef
Modified Altemeier Procedure as Management for Incarcerated Rectal Prolapse in a Young Healthy Male Patient: A Case Report and Literature Review
Leenah Abdulgader, Ebtesam Al-Najjar, Bayan Khasawneh, Abdullah Esmail
Medicina.2024; 60(11): 1872. CrossRef
Traitement chirurgical du prolapsus rectal complet de l’adulte
C. Korkmaz, G. Meurette
EMC - Techniques chirurgicales - Appareil digestif.2023; 40(4): 1. CrossRef

Case Report

Malignant disease, Rectal cancer,Colorectal cancer,Complication

Neorectal Mucosal Prolapse After Intersphincteric Resection for Low-Lying Rectal Cancer: A Case Report: Mohammed Alessa, Hyeon Woo Bae, Homoud Alawfi, Ahmad Sakr, Fozan Sauri, Nam Kyu Kim; Ann Coloproctol. 2021;37(Suppl 1):S15-S17. Published online April 22, 2021; DOI: https://doi.org/10.3393/ac.2020.02.22

5,434 View
92 Download
6 Web of Science
7 Citations

Abstract PDF

Radical resection for low rectal cancer is the mainstay among the treatment modalities. Intersphincteric resection (ISR) is considered a relatively new but effective surgical treatment for low-lying rectal tumor. As the sphincter preserving techniques get popularized, we notice uncommon complication associated with it in the form of rectal mucosal prolapse. We presented 2 rare cases that developed neorectal mucosa prolapse after ISR a complication following low rectal cancer surgery. Although ISR is a safe and effective surgical technique for low rectal cancer, it should be considered to correct modifiable possible risk factors. Also, Delorme procedure is good option for management of neorectal mucosal prolapse.

Citations

Citations to this article as recorded by

Tailoring rectal cancer surgery: Surgical approaches and anatomical insights during deep pelvic dissection for optimal outcomes in low‐lying rectal cancer
Youn Young Park, Nam Kyu Kim
Annals of Gastroenterological Surgery.2024; 8(5): 761. CrossRef
Treatment of side limb full-thickness prolapse of the side-to-end coloanal anastomosis following intersphincteric resection: a case report and review of literature
Guglielmo Niccolò Piozzi, Krunal Khobragade, Seon Hui Shin, Jeong Min Choo, Seon Hahn Kim
Annals of Coloproctology.2024; 40(Suppl 1): S38. CrossRef
Surgical Treatment for Mucosal Prolapse after Intersphincteric Resection
Rina Takahashi, Makoto Takahashi, Yuki Ii, Megumi Kawaguchi, Hirotaka Momose, Shunsuke Motegi, Ryoichi Tsukamoto, Yu Okazawa, Masaya Kawai, Kiichi Sugimoto, Yutaka Kojima, Kazuhiro Sakamoto
Nippon Daicho Komonbyo Gakkai Zasshi.2023; 76(3): 299. CrossRef
Unveiling the profound advantages of total neoadjuvant therapy in rectal cancer: a trailblazing exploration
Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim, Donghyoun Lee, Chinock Cheong
Annals of Surgical Treatment and Research.2023; 105(6): 341. CrossRef
Clinical outcome of the Gant-Miwa-Thiersch procedure for colonic mucosal prolapse after intersphincteric resection—a single-center report from Japan
Toshikatsu Nitta, Masatsugu Ishii, Jun Kataoka, Sedakatsu Senpuku, Yasuhiko Ueda, Ryo Iida, Ayumi Matsutani, Takashi Ishibashi
Annals of Medicine and Surgery.2021; 72: 103005. CrossRef
Robotic Intersphincteric Resection for Low Rectal Cancer: Technical Controversies and a Systematic Review on the Perioperative, Oncological, and Functional Outcomes
Guglielmo Niccolò Piozzi, Seon Hahn Kim
Annals of Coloproctology.2021; 37(6): 351. CrossRef
Surgical Treatment of Low-Lying Rectal Cancer: Updates
Cristopher Varela, Nam Kyu Kim
Annals of Coloproctology.2021; 37(6): 395. CrossRef

Original Articles

Benign proctology,Biomarker & risk factor

Factors Predicting the Presence of Concomitant Enterocele and Rectocele in Female Patients With External Rectal Prolapse: Akira Tsunoda, Tomoko Takahashi, Kenji Sato, Hiroshi Kusanagi; Ann Coloproctol. 2021;37(4):218-224. Published online January 12, 2021; DOI: https://doi.org/10.3393/ac.2020.07.16

6,627 View
144 Download
4 Web of Science
5 Citations

Abstract PDF

Purpose
External rectal prolapse (ERP) is frequently associated with other pelvic disorders, such as enterocele, rectocele, and perineal descent. Evacuation proctography makes it possible to visualize the development of such anatomical abnormalities. The aim of this study was to identify the variables that would predict associated abnormalities in patients with ERP.
Methods
Between February 2010 and August 2019, 124 female patients with ERP, who were evaluated using proctography were included in this study. Enterocele was diagnosed when the extension of the loop of the small bowel was located between the vagina and rectum. A significant rectocele was defined as >20 mm in diameter. Multivariate analysis was used to establish which morphological parameters best predicted the presence of enterocele or rectocele.
Results
Sixty-five patients had ERP alone, while 59 patients (47.6%) had additional findings on proctography. The most frequently associated abnormality was enterocele with 48 of the patients (38.7%) having this condition. Rectocele was detected in 17 of the 124 patients (13.7%). The median length of the ERP was 30 mm (range, 7 to 147 mm). The results of the stepwise multiple regression analysis showed that a history of hysterectomy and the length of the ERP were significantly associated with the presence of enterocele. The analysis showed that the longer the prolapse, the higher the incidence of enterocele. A history of hysterectomy was also significantly associated with the presence of rectocele.
Conclusion
Patients with ERP often have associated anatomical abnormalities and should be investigated thoroughly before planning surgical treatment.

Citations

Citations to this article as recorded by

Transverse perineal support improves long-term outcomes in patients undergoing stapled transanal rectal resection for obstructed defecation syndrome: a multicenter observational case-control study
Adolfo Renzi, Luigi Marano, Pasquale Talento, Luigi Brusciano, Angela Pezzolla, Domenico Izzo, Carmine Antropoli, Francesco D’Aniello, Giandomenico Di Sarno, Gianluca Minieri, Grazia Cantore, Gianmattia Terracciano, Domenico Barbato, Ludovico Docimo, Mass
Annals of Coloproctology.2025; 41(4): 330. CrossRef
Small intestine prolapse after vaginal hysterectomy with vaginal dome rupture. A clinical case
Aydar M. Ziganshin, Irina G. Mukhametdinova, Victoria F. Allayarova, Elina A. Shayhieva
Journal of obstetrics and women's diseases.2023; 71(6): 107. CrossRef
Comments on: factors predicting the presence of concomitant enterocele and rectocele in female patients with external rectal prolapse
Ingrid Melo-Amaral, Adrian Teran-Cardoza, Cristopher Varela
Annals of Coloproctology.2022; 38(1): 93. CrossRef
Robot-Assisted Colorectal Surgery
Young Il Kim
The Ewha Medical Journal.2022;[Epub] CrossRef
Treatment of Hemorrhoid in Unusual Condition-Pregnancy
Hyo Seon Ryu
The Ewha Medical Journal.2022;[Epub] CrossRef

Comparison of Delorme-Thiersch Operation Outcomes in Men and Women With Rectal Prolapse: Keehoon Hyun, Seo-Gue Yoon; Ann Coloproctol. 2019;35(5):262-267. Published online October 31, 2019; DOI: https://doi.org/10.3393/ac.2018.10.15.1

5,686 View
91 Download
4 Web of Science
6 Citations

Abstract PDF

Purpose
The laparoscopic rectopexy has become increasingly popular with verified stability, surgical route selection should be tailored to individual patient characteristics rather than operative risk. The perineal approach is useful in young male patients who need to preserve fertility. This study aimed to compare the characteristics of men and women who underwent Delorme-Thiersch procedures and analyze the postoperative outcomes of the perineal approach by sex.
Methods
We retrospectively reviewed the medical records of 293 patients who underwent Delorme-Thiersch operations in Seoul Song Do Colorectal Hospital between January 2011 and September 2017. Patient clinical characteristics and postoperative complications were analyzed by sex. We analyzed surgical outcomes with preoperative and 3-month postoperative incontinence questionnaires, constipation levels, and anal manometry.
Results
In this study, men with rectal prolapse were younger than women with the same condition. American Society of Anesthesiologists physical status classifications were higher in women and women had more L-spine X-ray and pudendal nerve terminal motor latency test abnormalities. Anorectal manometry pressures were higher in men. Men also had longer operation times and hospital stays and more postoperative complications (8 T ring infections, 6 patients with bleeding, 3 with strictures, 2 with severe pain, and 2 with rectal perforations). The recurrence rate was higher among women.
Conclusion
Men with rectal prolapse were younger, healthier, and had relatively better anorectal function than women. The Delorme-Thiersch operation in men promoted lower recurrence rates and was advantageous in preserving the fertility of young patients, but the incidence of complications was also higher in men. Adequate counseling and preparation for the possibility of complications are needed.

Citations

Citations to this article as recorded by

Laparoscopic anterior and posterior rectopexy using two mesh implants for rectal prolapse in men
A.L. Goncharov, A.S. Aslanyan, M.A. Chicherina, I.I. Muratov, T.V. Khorobrykh
Pirogov Russian Journal of Surgery.2025; (10): 73. CrossRef
Assessment of Laparoscopic Posterior Mesh Rectopexy for Complete Rectal Prolapse: A Case Series with Review of Literature
Vishal Chawda, Abhijit Joshi
International Journal of Recent Surgical and Medical Sciences.2023; 09(01): 059. CrossRef
A comparative study on the surgical options for male rectal prolapse
Han Deok Kwak, Jun Seong Chung, Jae Kyun Ju
Journal of Minimal Access Surgery.2022; 18(3): 426. CrossRef
Clinical outcomes of surgical management for recurrent rectal prolapse: a multicenter retrospective study
Kwang Dae Hong, Keehoon Hyun, Jun Won Um, Seo-Gue Yoon, Do Yeon Hwang, Jaewon Shin, Dooseok Lee, Se-Jin Baek, Sanghee Kang, Byung Wook Min, Kyu Joo Park, Seung-Bum Ryoo, Heung-Kwon Oh, Min Hyun Kim, Choon Sik Chung, Yong Geul Joh
Annals of Surgical Treatment and Research.2022; 102(4): 234. CrossRef
Longer prolapsed rectum length increases recurrence risk after Delorme’s procedure
Taro Tanabe, Emi Yamaguchi, Takuya Nakada, Risa Nishio, Kinya Okamoto, Tetsuo Yamana
Annals of Coloproctology.2022; 38(4): 314. CrossRef
Perineal stapled prolapse resection in combination with Thiersch operation for relapsed rectal prolapse: a case report
Teppei Kamada, Hironori Ohdaira, Junji Takahashi, Yoshinobu Fuse, Wataru Kai, Keigo Nakashima, Yuichi Nakaseko, Norihiko Suzuki, Masashi Yoshida, Takeo Usui, Yutaka Suzuki
Surgical Case Reports.2021;[Epub] CrossRef

Laparoscopic Posterolateral Rectopexy for the Treatment of Patients With a Full Thickness Rectal Prolapse: Experience With 63 Patients and Short-term Outcomes: Keehoon Hyun, Shi-Jun Yang, Ki-Yun Lim, Jong-Kyun Lee, Seo-Gue Yoon; Ann Coloproctol. 2018;34(3):119-124. Published online June 30, 2018; DOI: https://doi.org/10.3393/ac.2018.01.31

8,428 View
187 Download
5 Web of Science
5 Citations

Abstract PDF

Purpose
Although numerous procedures have been proposed for the treatment of patients with a rectal prolapse, the most effective operation has not yet been established. Minimal rectal mobilization can prevent constipation; however, it is associated with increased recurrence rates. We describe our novel method for a laparoscopic posterolateral rectopexy, which includes rectal mobilization with a posterior-right unilateral dissection, suture fixation to the sacral promontory with a polypropylene mesh (Optilene), and a mesorectal fascia propria that is as wide as possible. The present report describes our novel method and assesses the short-term outcomes of patients.
Methods
Between June 2014 and June 2017, 63 patients (28 males and 35 females) with a full-thickness rectal prolapse underwent a laparoscopic posterolateral (LPL) rectopexy. We retrospectively analyzed the clinical characteristics and postoperative complications in those patients. The outcome of surgery was determined by evaluating the answers on fecal incontinence questionnaires, the results of anal manometry preoperatively and 3 months postoperatively, the patients’ satisfaction scores (0–10), and the occurrence of constipation.
Results
No recurrence was reported during follow-up (3.26 months), and 3 patients reported postoperative complications (wound infection, postoperative sepsis, which was successfully treated with conservative management, and retrograde ejaculation). Compared to the preoperative baseline, fecal incontinence at three months postoperatively showed an overall improvement. The mean patient satisfaction score was 9.55 ± 0.10, and 8 patients complained of persistent constipation.
Conclusion
LPL rectopexy is a safe, effective method showing good functional outcomes by providing firm, solid fixation for patients with a full-thickness rectal prolapse.

Citations

Citations to this article as recorded by

Anatomical and functional outcomes of rectal prolapse treatment with laparoscopic pelvic organ prolapse suspension versus laparoscopic ventral mesh rectopexy
Adel Zeinalpour, Alimohammad Bananzadeh, Mohammad Mostafa Safarpour, Sara Shojaei‐Zarghani, Seyede Saeideh Shahidinia, Seyed Vahid Hosseini, Ali Reza Safarpour
Surgical Practice.2025; 29(1): 26. CrossRef
Surgical outcomes on health-related quality of life in rectal prolapse: A systematic review and meta-analysis
Hannaneh Yousefi-Koma, Yassin Rahnama, Dorsa Najari, Fatemeh Fathabadi, Mojtaba Sedaghat, Alireza Kazemeini, Mohammad Reza Keramati, Amir Keshvari, Mohammad Sadegh Fazeli, Behnam Behboudi, Seyed Mohsen Ahmadi-Tafti
Techniques in Coloproctology.2025;[Epub] CrossRef
Clinical outcomes of surgical management for recurrent rectal prolapse: a multicenter retrospective study
Kwang Dae Hong, Keehoon Hyun, Jun Won Um, Seo-Gue Yoon, Do Yeon Hwang, Jaewon Shin, Dooseok Lee, Se-Jin Baek, Sanghee Kang, Byung Wook Min, Kyu Joo Park, Seung-Bum Ryoo, Heung-Kwon Oh, Min Hyun Kim, Choon Sik Chung, Yong Geul Joh
Annals of Surgical Treatment and Research.2022; 102(4): 234. CrossRef
Laparoscopic Posterolateral Suture Rectopexy for Recurrent Rectal Prolapse in Children
Sherif M. Shehata, Ahmed A. Elhaddad, Wael M. Abo Senna, Mohamed A. Shehat
Journal of Laparoendoscopic & Advanced Surgical Techniques.2019; 29(10): 1292. CrossRef
Changing Trend of Rectal Prolapse Surgery in the Era of the Minimally Invasive Surgery
Suk-Hwan Lee
The Journal of Minimally Invasive Surgery.2019; 22(4): 135. CrossRef

Laparoscopic Vaginal Suspension and Rectopexy for Rectal Prolapse: Shi-Jun Yang, Seo-Gue Yoon, Ki-Yun Lim, Jong-Kyun Lee; Ann Coloproctol. 2017;33(2):64-69. Published online April 28, 2017; DOI: https://doi.org/10.3393/ac.2017.33.2.64

8,333 View
106 Download
15 Web of Science
16 Citations

Abstract PDF

Purpose

Laparoscopic procedures for the treatment of patients with a rectal prolapse have gained increasing worldwide acceptance because they have lower recurrence and better functional outcome than perineal procedures. Nevertheless, ideal surgical methods are still not available. We propose a new surgical technique, laparoscopic vaginal suspension and rectopexy, for correcting a full-thickness rectal prolapse and/or middle-compartment prolapse. This study assessed the short-term outcomes for patients who underwent laparoscopic vaginal suspension and rectopexy.

Methods

Between April 2014 and April 2016, 69 female patients underwent laparoscopic vaginal suspension and rectopexy to correct a rectal prolapse. Demographics, medical histories, and surgical and follow-up details were collected from their medical records. In addition to the clinical outcome, we repeated defecation proctography and a questionnaire regarding functional results three months after surgery.

Results

No major morbidities or no mortalities occurred. The defecation proctography confirmed excellent anatomical result in all cases. Of 7 patients with combined middle-compartment prolapses, we observed good anatomical correction. During follow-up, full-thickness recurrence occurred in one patient. Preoperative fecal incontinence was improved significantly at 3 months (mean Wexner score: 12.35 vs. 7.71; mean FISI: 33.29 vs. 21.07; P < 0.001). Analysis of responses to the fecal incontinence quality of life (FIQOL) questionnaire showed overall improvement at 3 months compared to the preoperative baseline (mean pre- and postoperative FIQOL scores: 12.11 vs. 14.39; P < 0.004).

Conclusion

Laparoscopic vaginal suspension and rectopexy is a new combined procedure for the treatment of patients with rectal prolapses. It has excellent functional outcomes and minimal morbidity and can correct and prevent middlecompartment prolapses.

Citations

Citations to this article as recorded by

Surgical outcomes on health-related quality of life in rectal prolapse: A systematic review and meta-analysis
Hannaneh Yousefi-Koma, Yassin Rahnama, Dorsa Najari, Fatemeh Fathabadi, Mojtaba Sedaghat, Alireza Kazemeini, Mohammad Reza Keramati, Amir Keshvari, Mohammad Sadegh Fazeli, Behnam Behboudi, Seyed Mohsen Ahmadi-Tafti
Techniques in Coloproctology.2025;[Epub] CrossRef
Surgical and Functional Outcome of Laparoscopic Vaginal Suspension Combined with Suture Rectopexy for Management of Pelvic Organ Prolapse
Mohamed I. Abuelnasr, Ahmed M. F. Salama, Ahmed M. Nawar
Journal of Coloproctology.2024; 44(01): e1. CrossRef
Mesh-associated complications in minimally invasive ventral mesh rectopexy: a systematic review
Gabriel Fridolin Hess, Fabio Nocera, Stephanie Taha-Mehlitz, Sebastian Christen, Marco von Strauss Und Torney, Daniel C. Steinemann
Surgical Endoscopy.2024; 38(12): 7073. CrossRef
Modified robotic ventral rectopexy with folded single titanized mesh suspension for the treatment of complex pelvic organ prolapse
Bernardina Fabiani, Alessandro Sturiale, Lisa Fralleone, Claudia Menconi, Vittorio d'Adamo, Gabriele Naldini
Colorectal Disease.2023; 25(3): 453. CrossRef
Natural Orifice Transanal Endoscopic Rectopexy for Complete Rectal Prolapse: Prospective Evolution of a New Technique and Short-term Outcomes
Abhijit Chandra, Pritheesh Rajan, Vivek Gupta, Saket Kumar, Mahesh Rajashekhara, Ravi Patel, Bharat Sangal, Vikram Singh
Diseases of the Colon & Rectum.2023; 66(1): 118. CrossRef
Assessment of feasibility of abdominal mesh vaginorectopexy in the repair of multiple pelvic organ prolapse
Mohamed Mazloum Zakareya, Walid Galal Elshazly, Ahmed Mohamed Moaz, Bassem Khamis Hegazy
Alexandria Journal of Medicine.2023; 59(1): 15. CrossRef
A quantitative study to explore functional outcomes following laparoscopic ventral mesh rectopexy for rectal prolapse
O Olatunbode, S Rangarajan, V Russell, YKS Viswanath, A Reddy
The Annals of The Royal College of Surgeons of England.2022; 104(6): 449. CrossRef
Postoperative complications and pelvic organ prolapse recurrence following combined pelvic organ prolapse and rectal prolapse surgery compared with pelvic organ prolapse only surgery
Shannon L. Wallace, Youngwu Kim, Erica Lai, Shailja Mehta, Bertille Gaigbe-Togbe, Chiyuan Amy Zhang, Emily C. Von Bargen, Eric R. Sokol
American Journal of Obstetrics and Gynecology.2022; 227(2): 317.e1. CrossRef
A Collaborative Approach to Multicompartment Pelvic Organ Prolapse
Brooke Gurland, Kavita Mishra
Clinics in Colon and Rectal Surgery.2021; 34(01): 069. CrossRef
Postoperative complications and recurrence rates after rectal prolapse surgery versus combined rectal prolapse and pelvic organ prolapse surgery
Shannon L. Wallace, Ekene A. Enemchukwu, Kavita Mishra, Leila Neshatian, Bertha Chen, Lisa Rogo-Gupta, Eric R. Sokol, Brooke H. Gurland
International Urogynecology Journal.2021; 32(9): 2401. CrossRef
European Society of Coloproctology guidance on the use of mesh in the pelvis in colorectal surgery
Yasuko Maeda, Eloy Espin‐Basany, Kim Gorissen, Mia Kim, Paul‐Antoine Lehur, Lilli Lundby, Ionut Negoi, Gregor Norcic, P. Ronan O’Connell, Tero Rautio, Bart van Geluwe, Gabrielle H. van Ramshorst, Andrea Warwick, Carolynne J. Vaizey
Colorectal Disease.2021; 23(9): 2228. CrossRef
Transvaginal rectopexy using the Flex® Colorectal Drive Robotic System: a proof-of-concept approach to rectal prolapse
J. O. Paull, A. Graham, S. Parascandola, S. Hota, S. Stein, B. Umapathi, A. Abdullah, N. Pudalov, V. Obias
Techniques in Coloproctology.2020; 24(5): 471. CrossRef
Clinical efficacy of integral theory–guided laparoscopic integral pelvic floor/ligament repair in the treatment of internal rectal prolapse in females
Yang Yang, Yong-Li Cao, Yuan-Yao Zhang, Shou-Sen Shi, Wei-Wei Yang, Nan Zhao, Bing-Bing Lyu, Wen-Li Zhang, Dong Wei
World Journal of Clinical Cases.2020; 8(23): 5873. CrossRef
Clinical efficacy of integral theory–guided laparoscopic integral pelvic floor/ligament repair in the treatment of internal rectal prolapse in females
Yang Yang, Yong-Li Cao, Yuan-Yao Zhang, Shou-Sen Shi, Wei-Wei Yang, Nan Zhao, Bing-Bing Lyu, Wen-Li Zhang, Dong Wei
World Journal of Clinical Cases.2020; 8(23): 5876. CrossRef
Clinical Outcome and Surgical Technique of Laparoscopic Posterior Rectopexy Using the Mesh With Anti-adhesion Coating
Yasunori Matsuda, Masahiro Nishikawa, Satoshi Nishizawa, Yoshinori Yane, Hokuto Ushijima, Taigo Tokuhara
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2019; 29(4): e41. CrossRef
Comparison of Delorme-Thiersch Operation Outcomes in Men and Women With Rectal Prolapse
Keehoon Hyun, Seo-Gue Yoon
Annals of Coloproctology.2019; 35(5): 262. CrossRef

Case Report

Major Pelvic Bleeding Following a Stapled Transanal Rectal Resection: Use of Laparoscopy as a Diagnostic Tool: Giovanni Domenico Tebala, Abdul Qayyum Khan, Sean Keane; Ann Coloproctol. 2016;32(5):195-198. Published online October 31, 2016; DOI: https://doi.org/10.3393/ac.2016.32.5.195

5,989 View
35 Download
3 Web of Science
5 Citations

Abstract PDF

Stapled transanal rectal resection (STARR) and stapled hemorrhoidopexy (SH) are well-established techniques for treating rectal prolapse and obstructed defecation syndrome (ODS). Occasionally, they can be associated with severe complications. We describe the case of a 59-year-old woman who underwent STARR for ODS and developed a postoperative pelvic hemorrhage. A computed tomography (CT) scan revealed a vast pelvic, retroperitoneal hematoma and free gas in the abdomen. Laparoscopy ruled out any bowel lesions, but identified a hematoma of the pelvis. Flexible sigmoidoscopy showed a small leakage of the rectal suture. The patient was treated conservatively and recovered completely. Surgeons performing STARR and SH must be aware of the risk of this rare, but severe, complication. If the patient is not progressing after a STARR or SH, a CT scan can be indicated to rule out intra-abdominal and pelvic hemorrhage. Laparoscopy is a diagnostic tool and should be associated with intraluminal exploration with flexible sigmoidoscopy.

Citations

Citations to this article as recorded by

Severe Postoperative Bleeding After Stapled Hemorrhoidopexy: Incidence and Causes
Huabing Chen, Zaili Tang, Zhousong Wu, Renjie Shi
Indian Journal of Surgery.2021; 83(5): 1223. CrossRef
Update on obstructed defecation syndrome
Reem A. Alharbi
Saudi Surgical Journal.2021; 9(1): 1. CrossRef
Perirectal Hematoma and Intra-Abdominal Bleeding after Stapled Hemorrhoidopexy and STARR—A Proposal for a Decision-Making Algorithm
Georgi Popivanov, Piergiorgio Fedeli, Roberto Cirocchi, Massimo Lancia, Domenico Mascagni, Michela Giustozzi, Ivan Teodosiev, Kirien Kjossev, Marina Konaktchieva
Medicina.2020; 56(6): 269. CrossRef
Common operation, uncommon complication. Bleeding from superior haemorrhoidal artery after minimally invasive procedure for hemorrhoids – a case report
Janavikula Sankaran Rajkumar, Aluru Jayakrishna Reddy, Ravikumar Radhakrishnan, Anirudh Rajkumar, Syed Akbar, Dharmendra Kollapalayam Raman
Journal of Coloproctology.2019; 39(01): 070. CrossRef
A Rare Complication of Stapled Hemorrhoidopexy: Giant Pelvic Hematoma Treated with Super-Selective Percutaneous Angioembolization
Francesco Ferrara, Paolo Rigamonti, Giovanni Damiani, Maurizio Cariati, Marco Stella
Annals of Colorectal Research.2018;[Epub] CrossRef

Original Articles

Delorme's Procedure: An Effective Treatment for a Full-Thickness Rectal Prolapse in Young Patients: Mohammad Sadegh Fazeli, Ali Reza Kazemeini, Amir Keshvari, Mohammad Reza Keramati; Ann Coloproctol. 2013;29(2):60-65. Published online April 30, 2013; DOI: https://doi.org/10.3393/ac.2013.29.2.60

7,989 View
52 Download
17 Citations

Abstract PDF

Purpose

Delorme's procedure is infrequently applied in young adults because of its assumed higher recurrence rate. The aim of this prospective study was to assess the efficacy of the Delorme's technique in younger adults.

Methods

Fifty-two consecutive patients were entered in our study. We followed patients for at least 30 months. Their complaints and clinical exam results were noted.

Results

Our study included 52 patients (mean age, 38.44 years; standard deviation, 13.7 years). Of the included patients, 41 (78.8%) were younger than 50 years of age, and 11 (21.1%) were older than 50 years of age. No postoperative mortalities or major complications were noted. Minor complications were seen in 5 patients (9.6%) after surgery. The mean hospital stay was 2.5 days. In the younger group (age ≤50 years), fecal incontinence was improved in 92.3% (12 out of 13 with previous incontinence) of the patients, and recurrence was seen in 9.75% (4 patients). In the older group (age >50 years), fecal incontinence was improved in 20% (1 out of 5 with previous incontinence) of the patients, and recurrence was seen in 18.2% (2 patients). In 50% of the patients with a previous recurrence (3 out of 6 patients) following Delorme's procedure as a secondary procedure, recurrence was observed.

Conclusion

Delorme's procedure, especially in younger patients, is a relatively safe and effective treatment and should not be restricted to older frail patients. This procedure may not be suitable for recurrent cases.

Citations

Citations to this article as recorded by

Long-Term Outcomes of Transvaginal Sacrospinous Ligament Suture Rectopexy
Henry H. Chill, Alireza Hadizadeh, Angela Leffelman, Claudia Paya Ten, Cecilia Chang, Roger P. Goldberg, Ghazaleh Rostaminia
International Urogynecology Journal.2025; 36(7): 1425. CrossRef
Safety of concurrent transvaginal rectopexy at time of transvaginal apical prolapse repair: A comparative study
Henry H. Chill, Sonia Gilani, Alireza Hadizadeh, Cecilia Chang, Nani P. Moss, Roger P. Goldberg, Ghazaleh Rostaminia
European Journal of Obstetrics & Gynecology and Reproductive Biology.2025; 312: 114512. CrossRef
Management of recurrent external rectal prolapse. A single center experience
Alessandro Sturiale, Lisa Fralleone, Bernardina Fabiani, Claudia Menconi, Vittorio d'Adamo, Gabriele Naldini
Surgery Open Digestive Advance.2024; 14: 100137. CrossRef
Delorme's procedure for urgent rectal prolapse – A video vignette
A. Teresa Calderón Duque, Esther María Cano Pecharromán, Javier Broekhuizen Benítez, Laura Arriero Ollero, Lourdes Gómez Ruiz, Tomas Balsa Marín
Colorectal Disease.2023; 25(3): 513. CrossRef
External rectal prolapse: more than meets the eye
M. Yiasemidou, C. Yates, E. Cooper, R. Goldacre, I. Lindsey
Techniques in Coloproctology.2023; 27(10): 783. CrossRef
Delorme’s vs. Altemeier’s in the management of rectal procidentia: systematic review and meta-analysis
Pratik Bhattacharya, Mohammad Iqbal Hussain, Shafquat Zaman, Sophie Randle, Yousaf Tanveer, Nameer Faiz, Diwakar Ryali Sarma, Rajeev Peravali
Langenbeck's Archives of Surgery.2023;[Epub] CrossRef
What are the surgical options for recurrent rectal prolapse – retrospective single-center experience
Tomasz Kościński, Krzysztof Szmyt
Polish Journal of Surgery.2023; 96(1): 22. CrossRef
Trends in the surgical management of rectal prolapse: An Asian experience
Yvonne Ying‐Ru Ng, Emile John Kwong Wei Tan, Cherylin Wan Pei Fu
Asian Journal of Endoscopic Surgery.2022; 15(1): 110. CrossRef
Longer prolapsed rectum length increases recurrence risk after Delorme’s procedure
Taro Tanabe, Emi Yamaguchi, Takuya Nakada, Risa Nishio, Kinya Okamoto, Tetsuo Yamana
Annals of Coloproctology.2022; 38(4): 314. CrossRef
Surgical Treatment of Full-Thickness Rectal Prolapse (FTRP): a Case Series Analysis
Przemysław Ciesielski, Magdalena Szczotko, Małgorzata Kołodziejczak
Indian Journal of Surgery.2021; 83(3): 634. CrossRef
Procedimiento de Altemeier para la reparación de prolapso rectal tras resección anterior de recto interesfinteriana con escisión mesorrectal total por vía transanal
Eloy Maldonado Marcos, Pere Planellas Giné, Júlia Gil Garcia, Ramon Farrés Coll, Antoni Codina Cazador
Cirugía Española.2021; 99(5): 389. CrossRef
Altemeier procedure for rectal prolapse after intersphincteric low anterior resection with transanal total mesorectal excision
Eloy Maldonado Marcos, Pere Planellas Giné, Júlia Gil Garcia, Ramon Farrés Coll, Antoni Codina Cazador
Cirugía Española (English Edition).2021; 99(5): 389. CrossRef
Laparoscopic ventral mesh rectopexy vs Delorme's operation in management of complete rectal prolapse: a prospective randomized study
S. H. Emile, H. Elbanna, M. Youssef, W. Thabet, W. Omar, A. Elshobaky, T. M. Abd El‐Hamed, M. Farid
Colorectal Disease.2017; 19(1): 50. CrossRef
The evolution of evaluation and management of urinary or fecal incontinence and pelvic organ prolapse
Scott R. Steele, Madhulika G. Varma, David Prichard, Adil E. Bharucha, Sarah A. Vogler, Askin Erdogan, Satish S.C. Rao, Ann C. Lowry, Erin O. Lange, Glen M. Hall, Joshua I.S. Bleier, Anthony J. Senagore, Justin Maykel, Sook Y. Chan, Ian M. Paquette, Marie
Current Problems in Surgery.2015; 52(2): 17. CrossRef
Komplikationen nach Rektumprolapsoperationen
T.H.K. Schiedeck
Der Chirurg.2015; 86(8): 747. CrossRef
A systematic review of the literature on the surgical management of recurrent rectal prolapse
A. Hotouras, Y. Ribas, S. Zakeri, C. Bhan, S. D. Wexner, C. L. Chan, J. Murphy
Colorectal Disease.2015; 17(8): 657. CrossRef
Outcome of the Delorme procedure for the management of complete rectal prolapse in children
Mohamed Rabae
The Egyptian Journal of Surgery.2014; 33(4): 260. CrossRef

Delorme's Procedure for Complete Rectal Prolapse: Does It Still Have It's Own Role?: Sooho Lee, Bong-Hyeon Kye, Hyung-Jin Kim, Hyeon-Min Cho, Jun-Gi Kim; J Korean Soc Coloproctol. 2012;28(1):13-18. Published online February 29, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.1.13

12,631 View
42 Download
8 Citations

Abstract PDF

Purpose

Although there are more than a hundred techniques, including the transabdominal and the perineal approaches, for the repair of the rectal prolapsed, none of them is perfect. The best repair should be chosen not only to correct the prolapse but also to restore defecatory function and to improve fecal incontinence throughout the patient's lifetime. The aim of this retrospective review is to evaluate clinical outcomes of the Delorme's procedure for the management of the complete rectal prolapse.

Methods

A total of 19 patients (13 females and 6 males) with complete rectal prolapses were treated by using the Delorme's procedure in St. Vincent's Hospital, The Catholic University of Korea, from February 1997 to February 2007. Postoperative anal incontinence was evaluated using the Cleveland Clinic Incontinence Score.

Results

All 19 patients had incontinence to liquid stool, solid stool, and/or flatus preoperatively. Three (15.8%) patients reported recurrence of the rectal prolapse (at 6, 18, 29 months, respectively, after the operation). Information on postoperative incontinence was available for 16 of the 19 patients. Twelve of the 16 patients (75%) reported improved continence (5 [31.3%] were improved and 7 [43.7%] completely recovered from incontinence) while 4 patients had unchanged incontinence symptoms. One (6.3%) patient who did not have constipation preoperatively developed constipation after the operation.

Conclusion

The Delorme's procedure is associated with a marked improvement in anal continence, relatively low recurrence rates, and low incidence of postoperative constipation. This allows us to conclude that this procedure still has its own role in selected patients.

Citations

Citations to this article as recorded by

Transanal rectopexy for external rectal prolapse
Shantikumar Dhondiram Chivate, Meghana Vinay Chougule, Rahul Shantikumar Chivate, Palak Harshuk Thakrar
Annals of Coloproctology.2022; 38(6): 415. CrossRef
Epidemiological trends in surgery for rectal prolapse in England 2001–2012: an adult hospital population‐based study
Y. El‐Dhuwaib, A. Pandyan, C. H. Knowles
Colorectal Disease.2020; 22(10): 1359. CrossRef
Surgical Treatment of Rectal Prolapse in the Laparoscopic Era; A Review of the Literature
Akira Tsunoda
Journal of the Anus, Rectum and Colon.2020; 4(3): 89. CrossRef
Laparoscopic ventral mesh rectopexy vs Delorme's operation in management of complete rectal prolapse: a prospective randomized study
S. H. Emile, H. Elbanna, M. Youssef, W. Thabet, W. Omar, A. Elshobaky, T. M. Abd El‐Hamed, M. Farid
Colorectal Disease.2017; 19(1): 50. CrossRef
Perineal resectional procedures for the treatment of complete rectal prolapse: A systematic review of the literature
Sameh Hany Emile, Hossam Elfeki, Mostafa Shalaby, Ahmad Sakr, Pierpaolo Sileri, Steven D. Wexner
International Journal of Surgery.2017; 46: 146. CrossRef
Delorme’s Procedure for Complete Rectal Prolapse: A Study of Recurrence Patterns in the Long Term
Carlos Placer, Jose M. Enriquez-Navascués, Ander Timoteo, Garazi Elorza, Nerea Borda, Lander Gallego, Yolanda Saralegui
Surgery Research and Practice.2015; 2015: 1. CrossRef
Surgical treatments for rectal prolapse: how does a perineal approach compare in the laparoscopic era?
Monica T. Young, Mehraneh D. Jafari, Michael J. Phelan, Michael J. Stamos, Steven Mills, Alessio Pigazzi, Joseph C. Carmichael
Surgical Endoscopy.2015; 29(3): 607. CrossRef
Simultaneous Delorme's procedure and inter-sphinteric prosthetic implant for the treatment of rectal prolapse and faecal incontinence: Preliminary experience and literature review
Emanuel Cavazzoni, Emanuele Rosati, Valentina Zavagno, Luigina Graziosi, Annibale Donini
International Journal of Surgery.2015; 14: 45. CrossRef

Reviews

Rectal Prolapse: Review According to the Personal Experience: Seo-Gue Yoon; J Korean Soc Coloproctol. 2011;27(3):107-113. Published online June 30, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.3.107

9,999 View
82 Download
20 Citations

Abstract PDF

The aim of treatment of rectal prolapse is to control the prolapse, restore continence, and prevent constipation or impaired evacuation. Faced with a multitude of options, the choice of an optimal treatment is difficult. It is best tailored to patient and surgeon. Numerous procedures have been described and are generally categorized into perineal or abdominal approaches. In general, an abdominal procedure has associated with lower recurrence and better functional outcome than perineal procedures. The widespread success of laparoscopic surgery has led to the development of laparoscopic procedures in the treatment of complete rectal prolapse. In Korea, there has been a trend toward offering perineal procedures because of the high incidence of rectal prolapse in young males and its being a lesser procedure. Delorme-Thiersch procedure has appeal as a lesser procedure for patients of any age or risk category, especially for elderly low-risk patients, patients with constipation or evacuation difficulties, young males, and patients with symptomatic hemorrhoids or mucosal prolapse. Laparoscopic suture rectopexy is recommended for either low-risk female patients or patients who are concerned with postoperative aggravation of their incontinence.

Citations

Citations to this article as recorded by

A Case of Robotic Posterior Rectopexy for Full-thickness Rectal Prolapse
Shinsuke Suzuki, Teni Godai, Shin Kato, Atsushi Onodera, Kazuya Endo, Shizune Onuma, Yui Honjo, Junya Shirai, Masakatsu Numata, Yutaka Kumakiri, Shinichiro Suzuki, Yuji Yamamoto
Journal of the Anus, Rectum and Colon.2022; 6(1): 72. CrossRef
A Case of Laparoscopic Rectopexy for Rectal Prolapse after Intersphincteric Resection
Kensuke Nakamura, Hiromitsu Iwamoto, Kenji Matsuda, Yasuyuki Mitani, Yuki Mizumoto, Yuki Nakamura, Norio Takemoto, Toshihiro Sakanaka, Masato Tamiya, Hiroki Yamaue
Nippon Daicho Komonbyo Gakkai Zasshi.2022; 75(2): 71. CrossRef
Delorme surgery for colonic mucosal prolapse after intersphincteric resection
Satoshi Narihiro, Naoko Miura, Yuji Nishizawa, Hiro Hasegawa, Koji Ikeda, Koichi Teramura, Yuichiro Tsukada, Takeshi Sasaki, Masaaki Ito
Surgery Today.2021; 51(6): 916. CrossRef
Factors Predicting the Presence of Concomitant Enterocele and Rectocele in Female Patients With External Rectal Prolapse
Akira Tsunoda, Tomoko Takahashi, Kenji Sato, Hiroshi Kusanagi
Annals of Coloproctology.2021; 37(4): 218. CrossRef
Laparoscopic Sutureless Rectopexy Using a Fixation Device for Complete Rectal Prolapse
Shinobu Tomochika, Nobuaki Suzuki, Shin Yoshida, Toshiyuki Fujii, Yukio Tokumitsu, Yoshitaro Shindo, Michihisa Iida, Shigeru Takeda, Shoichi Hazama, Hiroaki Nagano
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2021; 31(5): 608. CrossRef
Laparoscopic Pelvic Organ Prolapse Suspension (Pops) Versus Laparoscopic Ventral Mesh Rectopexy for Treatment of Rectal Prolapse: Prospective Cohort Study
Ahmed Farag, Abdrabou N. Mashhour, Mohamed Raslan, Mohamed Tamer, Mohamed Yehia Elbarmelgi
World Journal of Surgery.2020; 44(9): 3158. CrossRef
Short-Term Outcomes of Rectal Mucosa Sleeve Resection and Transverse Perineal Support Operation for Occult Rectal Prolapse, Rectocele and Descending Perineum: A Single Center and Single Team Experience
Francesco Cantarella, Enrico Magni
Annals of Colorectal Research.2019;[Epub] CrossRef
Comparison of Delorme-Thiersch Operation Outcomes in Men and Women With Rectal Prolapse
Keehoon Hyun, Seo-Gue Yoon
Annals of Coloproctology.2019; 35(5): 262. CrossRef
Usefulness of laparoscopic posterior rectopexy for complete rectal prolapse: A cohort study
Hiroki Hashida, Masato Sato, Yukiko Kumata, Motoko Mizumoto, Masato Kondo, Hiroyuki Kobayashi, Takehito Yamamoto, Hiroaki Terajima, Satoshi Kaihara
International Journal of Surgery.2019; 72: 109. CrossRef
Surgical Treatment of Rectal Prolapse: A 10-Year Experience at a Single Institution
Aeris Jane D. Nacion, Youn Young Park, Ho Seung Kim, Seung Yoon Yang, Nam Kyu Kim
The Journal of Minimally Invasive Surgery.2019; 22(4): 164. CrossRef
Laparoscopic Posterolateral Rectopexy for the Treatment of Patients With a Full Thickness Rectal Prolapse: Experience With 63 Patients and Short-term Outcomes
Keehoon Hyun, Shi-Jun Yang, Ki-Yun Lim, Jong-Kyun Lee, Seo-Gue Yoon
Annals of Coloproctology.2018; 34(3): 119. CrossRef
Conservative management of septic complication after internal Delorme procedure for occult rectal prolapse and rectocele in obstructed defecation syndrome
F. Cantarella, E. Magni
Techniques in Coloproctology.2018; 22(10): 817. CrossRef
Thiersch Procedure for Rectal Prolapse: Experiences From a Single Institution
Ren-Hao Chan, Bo-Wen Lin, Shao-Chieh Lin, Jenq-Chang Lee
International Surgery.2017; 102(1-2): 10. CrossRef
Laparoscopic ventral mesh rectopexy vs Delorme's operation in management of complete rectal prolapse: a prospective randomized study
S. H. Emile, H. Elbanna, M. Youssef, W. Thabet, W. Omar, A. Elshobaky, T. M. Abd El‐Hamed, M. Farid
Colorectal Disease.2017; 19(1): 50. CrossRef
Emergency Perineal Rectosigmoidectomy for Gangrenous Rectal Prolapse: a Single-Centre Experience with Review of Literature
Vijay Dattatraya Borgaonkar, Sushil Sharad Deshpande, Viraj Vijay Borgaonkar, Mukesh Dhondiram Rathod
Indian Journal of Surgery.2017; 79(1): 45. CrossRef
Simultaneous Delorme's procedure and inter-sphinteric prosthetic implant for the treatment of rectal prolapse and faecal incontinence: Preliminary experience and literature review
Emanuel Cavazzoni, Emanuele Rosati, Valentina Zavagno, Luigina Graziosi, Annibale Donini
International Journal of Surgery.2015; 14: 45. CrossRef
Laparoscopy for pelvic floor disorders
B. Van Geluwe, A. Wolthuis, A. D'Hoore
Best Practice & Research Clinical Gastroenterology.2014; 28(1): 69. CrossRef
Combined Aluminum Potassium Sulfate and Tannic Acid Sclerosing Therapy and Anal Encirclement Using an Elastic Artificial Ligament for Rectal Prolapse
Tatsuya Abe, Yoshikazu Hachiro, Masao Kunimoto
Diseases of the Colon & Rectum.2014; 57(5): 653. CrossRef
Comparison of abdominal and perineal procedures for complete rectal prolapse: an analysis of 104 patients
Jong Lyul Lee, Sung Soo Yang, In Ja Park, Chang Sik Yu, Jin Cheon Kim
Annals of Surgical Treatment and Research.2014; 86(5): 249. CrossRef
Procedures and Outcomes of Rectopexy for Rectal Prolapse
Yoshikazu Koide, Koutarou Maeda, Tsunekazu Hanai, Harunobu Satou, Kouji Masumori, Hiroshi Matsuoka, Hidetoshi Katsuno, Miho Siota, Tomoyoshi Endou, Shingi Matsuoka, Kouhei Hatta, Masahiro Mizuno, Kunihiro Tooyama
Nippon Daicho Komonbyo Gakkai Zasshi.2012; 65(10): 840. CrossRef

Surgical Treatment of Rectal Prolapse: Eung Jin Shin; J Korean Soc Coloproctol. 2011;27(1):5-12. Published online February 28, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.1.5

11,722 View
110 Download
34 Citations

Abstract PDF

Rectal prolapse is defined as a protrusion of the rectum beyond the anus. Although rectal prolapse was recognized as early as 1500 BC, the optimal surgical procedure is still debated. The varied operative procedures available for treating rectal prolapsed can be confusing. The aim of treatment is to control the prolapse, restore continence, and prevent constipation or impaired evacuation. In elderly and high-risk patients, perineal approaches, such as Delorme's operation and Altemeier's operation, have been preferred, although the incidence of recurrence and the rate of persistent incontinence seem to be high when compared with transabdominal procedures. Abdominal operations involve dissection and fixation of the rectum and may include a rectosigmoid resection. From the late twentieth century, the laparoscopic procedure has been applied to the treatment of rectal prolapse. Current laparoscopic surgical techniques include suture rectopexy, stapled rectopexy, posterior mesh rectopexy with artificial material, and resection of the sigmoid colon with colorectal anastomosis with or without rectopexy. The choice of surgery depends on the status of the patient and the surgeon's preference.

Citations

Citations to this article as recorded by

Extraperitoneal Anterior Suture Rectopexy (EASR): Feasibility Study
Abhijit Chandra, Deeban Ganesan, Arun Manoharan, Julie Shah, Utkarsh Srivastava, Pritheesh Rajan
Indian Journal of Surgery.2025; 87(4): 748. CrossRef
Addition of anal encirclement to perineal proctosigmoidectomy: a retrospective review
Aiya Amery, Kayla Marritt, Zarrukh Baig, Haven Roy, Dilip Gill, Nathan Ginther
Frontiers in Surgery.2025;[Epub] CrossRef
Unveiling the Hidden: A Case Report on Altemeier’s Surgical Triumph in Rectal Prolapse With Involvement of the Small Bowel
Kavita Jadhav, Ami Gandhi , Rukmini Waghmare, Dhanashri Sidam, Shubham More
Cureus.2025;[Epub] CrossRef
The effect of total colectomy with posterior suture rectopexy in patients with internal prolapse and colonic inertia; A case series on 9 women
Seyed Mostafa Tabatabaei, Seyed Hamzeh Mousavie, Hamed Vaseghi, Hossein Khadem Sedaghat, Mahdi Alemrajabi
International Journal of Surgery Case Reports.2025; 131: 111327. CrossRef
Safety of concurrent transvaginal rectopexy at time of transvaginal apical prolapse repair: A comparative study
Henry H. Chill, Sonia Gilani, Alireza Hadizadeh, Cecilia Chang, Nani P. Moss, Roger P. Goldberg, Ghazaleh Rostaminia
European Journal of Obstetrics & Gynecology and Reproductive Biology.2025; 312: 114512. CrossRef
Effect of concomitant use of hypertonic saline injection with anal cerclage for treatment of idiopathic partial rectal prolapse in children: a double hit therapy
Belal elezaby, Ahmed Arafat, wesam mahmoud, Sherif Kaddah, Mostafa Gad
Egyptian Pediatric Association Gazette.2025;[Epub] CrossRef
Rectal prolapse (62.2, 62.3), adults
Yu. A. Shelygin, S. I. Achkasov, D. V. Alyoshin, O. M. Biryukov, V. S. Groshilin, V. N. Kashnikov, I. V. Kostarev, N. V. Kostenko, A. I. Moskalev, A. A. Mudrov, A. V. Muravyov, N. V. Oleinik, V. V. Polovinkin, V. M. Тimerbulatov, A. Yu. Titov, O. Yu. Fome
Koloproktologia.2024; 23(3): 10. CrossRef
Rectal prolapse (62.2, 62.3), adults
Yu. A. Shelygin, S. I. Achkasov, D. V. Alyoshin, O. M. Biryukov, V. S. Groshilin, V. N. Kashnikov, I. V. Kostarev, N. V. Kostenko, A. I. Moskalev, A. A. Mudrov, A. V. Muravyov, N. V. Oleinik, V. V. Polovinkin, V. M. Тimerbulatov, A. Yu. Titov, O. Yu. Fome
Koloproktologia.2024; 23(3): 10. CrossRef
A network meta-analysis of surgical treatments of complete rectal prolapse
S. H. Emile, S. M. Khan, Z. Garoufalia, E. Silva-Alvarenga, R. Gefen, N. Horesh, M. R. Freund, S. D. Wexner
Techniques in Coloproctology.2023; 27(10): 787. CrossRef
Rectal prolapse associated with intussusception and malignancy
Timon Mac Sseruwagi, Catherine R Lewis
Journal of Surgical Case Reports.2023;[Epub] CrossRef
Transanal Rectal Resection by Circular Stapler for Rectal Prolapse
Ashwin Porwal, Paresh Gandhi, Deepak Kulkarni
World Journal of Colorectal Surgery.2022; 11(2): 32. CrossRef
The Surgical Management of Rectal Prolapse
Cristian Soare, Konstantinos Lasithiotakis, Helena Dearden, Shailendra Singh, Clare McNaught
Indian Journal of Surgery.2021; 83(S3): 694. CrossRef
Surgical Treatment of Full-Thickness Rectal Prolapse (FTRP): a Case Series Analysis
Przemysław Ciesielski, Magdalena Szczotko, Małgorzata Kołodziejczak
Indian Journal of Surgery.2021; 83(3): 634. CrossRef
Outcome of Fecal Incontinence in Patients with Rectal Prolapse Undergoing the Altemeier Procedure with or without Posterior Levatorplasty
Alimohammad Bananzadeh, Hamed Shariat Razavi, Shahin Khodaei, Maytham Hameed Al-Qanbar, Seyed Mohammad Kazem Tadayon, Seyed Vahid Hosseini, Leila Ghahramani
Journal of Coloproctology.2021; 41(01): 052. CrossRef
Rectal prolapse in children. Causes, diagnostics, treatment (a literature review)
E. S. Pimenova, G. A. Korolev
Russian Journal of Pediatric Surgery.2021; 25(3): 186. CrossRef
Incarcerated Rectal Procidentia: A Case Report and Review
Abdulqader M Albeladi, Ahmad Odeh, Aminah H AlAli, Abdullah M Alkhars, Kawther Boumarah, Hussain A Al Ghadeer, Sara A Alsaied, Ammar Omrani, Khadir Ahmed
Cureus.2021;[Epub] CrossRef
Laparoscopic Sutureless Rectopexy Using a Fixation Device for Complete Rectal Prolapse
Shinobu Tomochika, Nobuaki Suzuki, Shin Yoshida, Toshiyuki Fujii, Yukio Tokumitsu, Yoshitaro Shindo, Michihisa Iida, Shigeru Takeda, Shoichi Hazama, Hiroaki Nagano
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2021; 31(5): 608. CrossRef
Management of irreducible giant rectal prolapse
Adem Tuncer, Sami Akbulut, Zeki Ogut, Tevfik Tolga Sahin
International Journal of Surgery Case Reports.2021; 88(C): 106485. CrossRef
Epidemiological trends in surgery for rectal prolapse in England 2001–2012: an adult hospital population‐based study
Y. El‐Dhuwaib, A. Pandyan, C. H. Knowles
Colorectal Disease.2020; 22(10): 1359. CrossRef
Perineal repair of a full‐thickness rectal prolapse in a wild Sumatran orangutan (Pongo abelii)
Yenny Saraswati, Peter Sedman, Rebecca Sedman, Andika Pandu Wibisono, Citrakasih Nente, Meuthya Sr Simatupang, Ian Singleton, Romain Pizzi
Journal of Medical Primatology.2019; 48(1): 65. CrossRef
TRRPCS: a new promising technique in the treatment of rectal prolapse – a video vignette
A. Porwal
Colorectal Disease.2019; 21(4): 493. CrossRef
Usefulness of laparoscopic posterior rectopexy for complete rectal prolapse: A cohort study
Hiroki Hashida, Masato Sato, Yukiko Kumata, Motoko Mizumoto, Masato Kondo, Hiroyuki Kobayashi, Takehito Yamamoto, Hiroaki Terajima, Satoshi Kaihara
International Journal of Surgery.2019; 72: 109. CrossRef
Management of rectal prolapse (Guda Bhramsa) through Kshara Karma (chemical cauterisation) – a case study
Madan Bhandari, Basavaraj Chanda, Prasanna N. Rao, Gopikrishna B.J, Sahanasheela K.R
Journal of Coloproctology.2019; 39(04): 389. CrossRef
J-Pouch Prolapse as a Late Complication of Restorative Proctocolectomy
Remil Simon, Keith Hollister, J. Daniel Stanley, Shauna Lorenzo-Rivero
The American Surgeon™.2018; 84(9): 383. CrossRef
A systematic review of online resources to support patient decision-making for full-thickness rectal prolapse surgery
G. E. Fowler, D. M. Baker, M. J. Lee, S. R. Brown
Techniques in Coloproctology.2017; 21(11): 853. CrossRef
Perineal approach in strangulated rectal prolapse: early surgical intervention
Yakov Khromov, Nasser Sakran, Alexander Becker, Dan Hershko
ANZ Journal of Surgery.2017;[Epub] CrossRef
MESH ANOPLASTY- AN UNIQUE APPROACH TO RECTAL PROLAPSE
Renganathan D N, Jayakumar R, Venkadesan V S, Viggnesh P, Balaji D J
Journal of Evolution of Medical and Dental Sciences.2017; 6(16): 1303. CrossRef
A Novel Percutaneous Technique for Treating Complete Rectal Prolapse in Adults
Samir Ahmad Ammar, Mohamad B. M. Kottb
Surgical Innovation.2015; 22(3): 240. CrossRef
Thiersch wiring as a temporary procedure in a haemodynamically unstable patient with an incarcerated rectal procidentia
Ravikiran Naalla, Raghunath Prabhu, Rajgopal Shenoy, Inge Gerdina Joanna Hendriks
BMJ Case Reports.2014; 2014: bcr2014204822. CrossRef
A Simple and Safe Procedure to Repair Rectal Prolapse Perineally Using Stapling Devices
Fumitake Hata, Hidefumi Nishimori, Shinichiro Ikeda, Tomomi Yajima, Akihiko Nishio, Yuji Ishiyama
Case Reports in Gastroenterology.2014; 8(1): 39. CrossRef
Midterm Results After Perineal Stapled Prolapse Resection for External Rectal Prolapse
Diana Sehmer, Lukas Marti, Katja Wolff, Franc H. Hetzer
Diseases of the Colon & Rectum.2013; 56(1): 91. CrossRef
Evaluation and surgical treatment of rectal prolapse: an international survey
H. A. Formijne Jonkers, W. A. Draaisma, S. D. Wexner, I. A. M. J. Broeders, W. A. Bemelman, I. Lindsey, E. C. J. Consten
Colorectal Disease.2013; 15(1): 115. CrossRef
Ergebnisse im Langzeitverlauf nach staplerunterstützter transanaler Rektumresektion (STARR)
K. Köhler, S. Stelzner, G. Hellmich, D. Lehmann, T. Jackisch, B. Fankhänel, H. Witzigmann
coloproctology.2013; 35(3): 169. CrossRef
Results in the long-term course after stapled transanal rectal resection (STARR)
Katrin Köhler, Sigmar Stelzner, Gunter Hellmich, Dirk Lehmann, Thomas Jackisch, Bernhard Fankhänel, Helmut Witzigmann
Langenbeck's Archives of Surgery.2012; 397(5): 771. CrossRef

Original Articles

Transanal Posterior Anorectoplasty of Rectal Prolapse.: Kim, Jong Duck , Ye, Byung Kuk , Jo, Hong Jae , Oh, Nahm Gun; J Korean Soc Coloproctol. 2002;18(5):269-273.

1,477 View
10 Download

Abstract PDF: PURPOSE
Many different procedures for rectal prolapse have been described, but optional surgical treatment remains controversial. The aim of this report is to introduce an innovative and effective method of surgical treatment to restore anal continence and anatomic correction of rectal prolapse.
METHODS
Data were retrospectively collected and analyzed on 11 patients (7 male and 4 female) who underwent transanal posterior anorectoplasty for complete rectal prolapse between Jan. 1995 to Dec. 2000. This procedure is summarized to five steps as follows: 1. Partial resection of posterior rectal ampulla. 2. Longitudinal plication with posterior fixation. 3. Posterior levatorplasty. 4. One layer suture as longitudinal fashion. 5. Gant-Miwa operation-like procedure on anterior rectum.
RESULTS
There were no cases of postoperative infection and bleeding. There were no cases of recurrence of the rectal prolapse except 1 case of ant. mucosal prolapse which was successfully treated with one more Gant-Miwa operation-like procedure at postoperative 3 months. Fecal incontinence were in two cases at postoperative 12 months which were estimated as grade 2 by assessment of bowel function by Kirwan.
CONCLUSIONS
Although, the best operation for rectal prolapse remains controversial subject, authors believe that transanal posterior anorectoplasty should be considered as effective new surgical procedure for the treatment of rectal prolapse.

Thiersch Operation for the Treatment of Old Patients with Rectal Prolapse.: Park, Joon Cheol , Kim, Byung Seok , Moon, Duk Jin , Park, Ju Sup; J Korean Soc Coloproctol. 1998;14(3):523-530.

1,525 View
29 Download

Abstract PDF: Although many kinds of operation for rectal prolapse exist, generally they could be divided into the transabdominal and transperineal approach. The former has low recurrence rate as compared with the latter, but needs laparotomy. Unfortunately, many patients with rectal prolapse are old and debilitated. So they are not suitable candidates for a major abdominal operation. For those patient, a transperineal method may be proper, but the recurrence rate may be high and continence is not always achieved. We reviewed 12 patients who were older than 70 years of age and treated by the Thiersch operation among the 52 cases of rectal prolapse from Feb. 1992 to Mar. 1997 at Kwangju Christian Hospital. The results were summarized as follows; 1) The male to female ratio was 1 : 1.4. 2) Durations of rectal prolapse were distributed from 6 months to 30 years. Seven cases had duration of longer than 10 years. 3) The preoperative incidence of incontience was 8 (67%) of 12 cases. Among the 8 patients with incontinence, the male was 3 (37.5%) and female was 5 (62.5%). 4) Postoperative review of incontinence revealed complete disappearance in 4 cases (50%), improvement in 3 cases (37.5%), and no improvement in 1 case (12.5%). 5) After the Thiersch operation, rectal prolapse recurred in only 1 of the 12 cases (8.3%), a wound infection developed in 1 case (8.3%), defecation difficulty due to the small Thiersch ring was present in 3 cases (25%). The results of this study show that the Thiersch operation may be an effective method in treating rectal prolapse, especially in patient who are old or have poor general condition and manifested incontinence.

Anorectal Physiology in the Rectal Prolapse Patient.: Son, Kyung Soo , Joo, Jae Sik , Wexner, Steven D; J Korean Soc Coloproctol. 1998;14(3):467-476.

1,391 View
10 Download

Abstract PDF: PURPOSE
The aim of our study was to evaluate the physiological spectrum of anorectal dysfunction among patients with full thickness circunferential rectal prolapse. MATERIAL AND METHODS: Between January 1988 and March 1995, 88 patients who visited department colorectal surgery, Cleveland Clinic Florida with rectal prolapse were studied. There were 8 males and 80 females, with a mean age 69 (range 28~101) years. Patients underwent a detailed history and the following anorectal physiology tests were performed: anal canal manometry, pudendal nerve terminal motor latency (PNTML) assessment, anal electromyography and cinedefecography.4 standard continence scoring system, based on the frequency and type of incontinence (0=full continence, 20=complete incontinence) was used. Patients with rectal prolapse (n=88) were divided into two subgroups: Group I=continent patients (n=33) and Group II= incontinent patients (n=55).
RESULTS
There were statistically significant differences between each group when comparing mean resting pressures, anal pressures, anal canal length, rectal compliance, rectoanal inhibitory reflex, increased fiber density, the occurrence of premature evacuation (p<0.001), and rectal capacity (p<0.05). However, dynamic changes of anorectal angle, resting anorectal angle, puborectalis length, and rectal sensitivity were not significantly different (p>0.05) between groups.
CONCLUSION
Continence may be disturbed in patients with rectal prolapse; knowledge of impairment in continence may assist in surgical management.

Laparoscopic Suture Rectopexy for Rectal Prolapse.: Yoon, Seo Gue , Kim, Khun Uk , Noh, Khun Young , Lee, Jung Kyun , Kim, Kwang Yun; J Korean Soc Coloproctol. 2002;18(2):89-94.

1,687 View
50 Download

Abstract PDF: PURPOSE
This study was undertaken to eveluate the early results of the laparoscopic suture rectopexy in the treatment of rectal prolapse.
METHODS
From May 1999 to July 2001, laparoscopic suture rectopexy (LSR) was successfully performed in 26 patients and the results were compared to those of 5 patients with open suture rectopexy (OSR) and 6 patients with open resection rectopexy (ORR). Preoperative and postoperative functional assessment included Wexner's incontinence score, constipation score, and anorectal manometry.
RESULTS
Immediate postoperative morbidity was minimal in all groups. Bowel function was resumed significantly sooner (P=0.001), the numbers of the analgesics injection were significantly fewer (P<0.001) and postoperative hospital stay was significantly shorter (P<0.001) in the LSR than in the open groups. Postoperatively, the anal resting and squeezing pressures increased slightly and Wexner's incontinence score decreased significantly in all groups of patients. Constipation score decreased slightly in all groups of patients after surgery. There was one mucosal prolapse recurrence after surgery in the LSR.
CONCLUSIONS
Laparoscopic suture rectopexy for rectal prolapse can be performed safely. Recovery is uneventful and of shorter duration after the laparoscopic than after the open approach. Functional results are obtained similarly with both approaches.

Case Report

A Case Report of Colorectoanal Intussusception.: Lee, Sang Jeon , Park, Jin Woo; J Korean Soc Coloproctol. 1998;14(2):305-308.

1,275 View
3 Download

Abstract PDF: Colorectoanal intussusception is a rare and distinct entity that differs from the more common rectal prolapse. Typically the intussusception occurrs with tumor at the apex of the intussuscepted segment acting as lead point. Here we present a case and review the literature of colorectoanal intussusception. The case presented here is that of an elderly woman with a proximal sigmoid colon cancer at its apex. Anterior resection was electively performed after reduction of the intussusception. It is important to differentiate a colorectoanal intussusception from the more common rectal prolapse because treatment may differ. The anorectum remains in its normal anatomic position in colorectoanal intussusception, whereas the anal canal is effaced with the prolapsed segment of bowel in rectal prolapse. Identification of a tumor at the apex of the intussuscepted bowel should also arouse suspicion that the condition is not a rectal prolapse.

Original Articles

Pathogenesis and Surgical Treatment of Rectal Prolapse Syndrome.: Kim, Jin Cheon , Kim, Chang Nam , Park, Sang Kyu , Kim, Sook Young , Yu, Chang Sik; J Korean Soc Coloproctol. 1998;14(2):225-234.

1,504 View
22 Download

Abstract PDF: The rectal prolapse syndome is a disease entity includes rectocele and rectal prolapse, presenting prolapse(procidentia) of rectum. In rectocele, rectum is prolapsed anteriorly into the vagina, whereas in procidentia, inferiorly out of the anus. This study was aimed at analyzing pathogenesis and adequacy of surgical treatment in rectocele and rectal prolapse. Twenty-one patients with rectocele and 18 patients with rectal prolapse were assessed pre- and post-operatively in respect to symptoms and signs, pathogenesis, defecography, and manometry. In analysis of symptoms and sings, constipation was the commonest in both diseases(86% of rectocele and 67% of rectal prolapse) and incontinence was not infrequently found in both diseases as well(14% of rectocele and 33% of rectal prolapse). In analysis of the underlying causes, two patients with rectal prolapse had prolapse from childhood. Defecography showed anorectal angle of rectal prolapse in rest and push period. They were significantly wider than those of rectocele(p<0.05). The perineal descent of rectal prolapse was longer than that of rectocele. In analysis of the associated factors, average number of delivery was more than three times in both diseases(3.5 of rectocele and 5.1 of rectal prolapse). We could easily find previous operation history in both diseases. Among them, hysterectomy was the most frequent, especially in patients with rectocele. The hemorrhoids was associated more common in rectocele than in rectal prolapse(p<0.05). Preoperative maximal resting pressure of rectal prolapse was more significantly decreased than that of rectocele(p<0.05). The sensation of fullness was significantly decreased in patients with rectal prolapse postoperatively(p<0.05). Patients with rectocele underwent levator plication by transrectal or vaginal approach. Patients with rectal prolapse underwent posterior rectopexy in 11 patients, resection and rectopexy in 3 patients, Delorme's operation and Thiersch operation in 2 patients each. Constipation was significantly improved in patients with rectocele postoperatively(p<0.05). Incontinence was markedly improved in patients with rectal prolapse postoperatively(p<0.05). At the interview about subjective improvement of symptom, 95% of patients with rectocele and 89% of patients with rectal prolapse were satisfied with surgery. In conclusion, rectocele and rectal prolapse can be categorized as rectal prolapse syndrome because both diseases have anatomical derangements caused by similar pathogenesis such as altered bowel habits, anatomical factor, delivery, past history of hysterectomy, and hemorrhoids. Levator plication and posterior rectopexy seem to be useful surgical methods of anatomical repair for the respective disease.

Perineal Rectosigmoidectomy with Levatoroplasty for Rectal Prolapse Early functional outcome.: Yoon, Seo Gue , Lee, Jong Ho , Yoon, Jong Seob , Kim, Kuhn Uk , Kim, Hyun Shig , Lee, Jong Kyun , Kim, Kwang Yun; J Korean Soc Coloproctol. 2001;17(5):220-226.

1,436 View
33 Download

Abstract PDF: PURPOSE
This study was designed to analyze the short-term clinical and functional outcomes of perineal rectosigmoidectomy with levatoroplasty for complete rectal prolapse.
METHODS
The data were prospectively collected and consisted of the clinical data, the functional status before and after surgery, the operation record, and the postoperative course. The functional status was evaluated by using Wexner's constipation score (0-30), Wexner's incontinence score (0-20), anorectal manometry, and pudendal nerve terminal motor latency. Follow-up was performed at 3-6 months after the operation by using both a standardized questionnaire completed in the outpatient clinic or telephone interview (n=23) and an anorectal physiology test (n=7).
RESULTS
During a one-year period, 23 patients (male=10) underwent perineal rectosigmoidectomy with levatoroplasty for complete rectal prolapse. The median duration of the operations was 88 minutes. The median length of postoperative hospital stay was 6 days. There was one urinary tract infection and no mortalities. The constipation score was significantly decreased after the operation (9.8 vs 3.8; P<0.001), and constipation was improved in 90 percent (19/21) of the cases. The incontinence score was significantly decreased after surgery (mean preop.=11.6, postop.=3.7; P<0.001) and incontinence was improved in 17 of 21 patients with impaired continence (81 percent). Anal sphincter function was not improved but rectal reservoir capacity was significantly decreased after surgery (rectal urgent volume (45.7 cc vs 37.1 cc; P=0.045), maximal tolerable volume (120 cc vs 85.7; P=0.011). Most patients (83 percent) felt that the operation had improved their symptoms. The major reasons for dissatisfaction after surgery were frequent defecation, fecal soiling, persistent or aggravated fecal incontinence, and recurrence. One patient had a complete recurrence (4.3 percent), and another patient had a mucosal prolapse which was treated.
CONCLUSIONS
Perineal rectosigmoidectomy with levatoroplasty for complete rectal prolapse is a safe technique with acceptable short-term functional results; however, it is not recommended for rectal prolapse patients with diarrhea-predominant irritable bowel syndrome.

Case Report

Complete Rectal Prolapse Combined with Rectal Cancer: A Case Report.: Lee, Tae Soon , Bae, Ok Suk , Park, Sung Dae; J Korean Soc Coloproctol. 2005;21(3):178-180.

1,515 View
21 Download

Abstract PDF: Colorectal cancer and rectal prolapse occur more frequently in elderly patients. Although the relationship between complete rectal prolapse and colorectal cancer has not yet been clarified, when both diseases develop simultaneously in a patient, it may be due to just coincidence or to a promotion of prolapse due to accelerated constipation caused by cancer. Thus, patients with a sudden onset of rectal prolapse should be screened for colorectal cancer. We report a case of complete rectal prolapse combined with early rectal cancer in a 75 year-old woman who was successfully treated with a perineal rectosigmoidectomy.

Original Articles

Factors Influencing Fecal Incontinence in Complete Rectal Prolapse: A Prospective Analysis.: Yoon, Seo Gue , Lee, Kwang Real , Kim, Khun Uk , Song, Seok Kyu , Kim, Chil Seok , Lee, Jong Kyun , Kim, Kwang Yun; J Korean Soc Coloproctol. 2001;17(1):7-14.

1,343 View
8 Download

Abstract PDF: PURPOSE
This study was undertaken to identify factors influencing fecal incontinence in rectal prolapse.
METHODS
The clinical and anorectal physiologic data (anal manometry, rectal sensitivity test, pudendal nerve terminal motor latency (PNTML)) of 42 complete rectal prolapse patients were collected in a prospective database and were analyzed according to Wexner's incontinence score (0-20).
RESULTS
The mean Wexner's incontinence score was 10.6. Females (n=24) were more prone to be incontinent than males (n=18)(incontinence score 14.8 vs 5.1, p<0.001). A linear regression analysis showed that increased age (r= 0.497, p=0.001), decreased maximum resting pressure (MRP) (r= 0.686, p<0.001), decreased maximum squeezing pressure (MSP)(r= 0.789, p<0.001), decreased maximal rectal tolerable volume (MTV) (r= 0.386, p=0.012) influenced the incontinence score. An absent rectoanal inhibitory reflex (RAIR) was not related to incontinence, but was related to significantly low resting anal pressure. Delayed PNTML did not influence incontinence or the MSP. In a multiple regression analysis, decreased MRP (beta= 0.383; p=0.002), decreased MSP (beta= 0.345; p =0.007) and female gender (beta=0.343; p=0.006) influenced incontinence significantly.
CONCLUSIONS
Major factors influencing fecal incontinence in complete rectal prolapse were decreased MRP and MSP. Female patients were more prone to fecal incontinence than males. RAIR and MTV were not significant factors. PNTML did not show any relation to incontinence score or the anal pressure.

Results of Delorme's Procedure for Rectal Prolapse.: Byun, Sung Whan , Kim, Han Sun; J Korean Soc Coloproctol. 2000;16(6):407-414.

1,587 View
23 Download

Abstract PDF: PURPOSE
This retrospective study was designed to review and analyze the results of Delorme's procedure for rectal prolapse.
METHODS
Between 1990 and 1999, twenty-nine patients with rectal prolapse underwent Delorme's procedure. These patients had had no previous operation for rectal prolapse. This study was proceeded retrospectively through the out-patient clinic and by telephone questionnare.
RESULTS
Twelve cases (41%) were males and 17 cases (59%) were females. Mean age was 55.5 years (range, 23~86 years). The duration of the symptoms was ranged from 3 months to 60 years, with the mean period of 12.2 years. The follow-up period after the operation was from 3 months to 10 years (mean follow-up, 45 months). The internal rectal prolapses were 11 cases (38%), and the complete rectal prolapses were 18 cases (62%). The common preoperative bowel habits were incontinence with 6 cases (21%) and constipation with 10 cases (34%). After the operation, incontinence and constipation were improved in 4 cases (67%) and 6 cases (60%) respectively. Additional 2 cases of constipation occurred among 19 cases who hadn't had it preoperatively but the use of laxative helped in improving the symptom. The mean operation time was 71 minutes and in 24 cases (83%), the operation was proceeded with spinal anesthesia. In 27 cases (93%), the amount of bleeding during the operation was less than 100 cc, and in 1 case (3.4%), blood transfusion was needed because the amount was more than 400 cc. The three patients (10%) had postoperative complications(one perianal abscess due to anastomotic dehiscence and two urinary retention). There was one case of recurrence (3.4%) after the operation and no postoperative mortality.
CONCLUSIONS
Delorme's procedure has the short operation time, causes less bleeding and is possible with regional anesthesia. Delorme's procedure has low complication rate, results in good bowel function and has a low recurrence rate. Therefore, Delorme's procedure can be performed with satisfactory outcome in elderly patients and the poor general conditioned patients as well as younger patients. As recurrence rates is low and continence is improved, this procedure may be the preferred initial treatment of all patients with rectal prolapse.

Clinical and Physiologic Characteristics of Rectal Prolapse in Males.: Yoon, Seo Gue , Lee, Kwang Real , Cho, Kyung A , Hwang, Do Yean , Kim, Khun Uk , Kang, Young Won , Park, Weon Kap , Kim, Hyun Sik , Lee, Jung Kyun , Kim, Kwang Yun; J Korean Soc Coloproctol. 2000;16(4):223-230.

1,694 View
31 Download

Abstract PDF: This study compares the sexual differences among rectal prolapse patients regarding the clinical and the physiologic characteristics with emphasis on males.
METHODS
The clinical data, functional status and operative records of 43 patients, who had completed both clinical and functional evaluations were collected in a prospective database and were analyzed according to sex. The functional status of the patients was evaluated by Wexner's constipation score (0~30), Wexner's incontinence score (0~20), anorectal manometry, and pudendal nerve terminal motor latency (PNTML).
RESULTS
The incidences of rectal prolapse in males (n=22) and in females (n=21) were similar. The age of onset for males was lower (mean standard deviation, 19.6 19.59 (50% in childhood) vs 52.0 20.75 years; p=0.001) and the duration of symptoms was longer (31.5+/-19.87 vs 12.5+/-14.31 years; p<0.001). Surgery in males was most commonly performed during the sexually active years (51.2+/-16.34 vs 64.5+/-13.19; p=0.006). The incidence of mucosal prolapse in males was higher (10/22 vs 4/17; p=0.065). The incidences and the severities of defecation difficulty in males and females were similar (n=12, mean Wexner score=8.4 vs n=12, mean Wexner score=9.9; p=NS) but, the incidences and the severities of fecal incontinence were lower in males (n=4, mean Wexner score=4.3 vs n=17, mean Wexner score= 14.2; p<0.001). The maximum resting pressure was higher in males (39.2+/-21.46 vs 26.3+/-19.98 mmHg; p=0.049), and the maximum squeezing pressure was better preserved (131.2+/-62.63 vs 67.5+/-37.99 mmHg; p<0.001). No significant difference existed in the PNTML. Female patients underwent abdominal resection rectopexy (n=6), perineal rectosigmoidectomy with lavatoroplasty (n=11), and Delorme's procedure (n=4), but all male patients preferred the perineal approach (rectosigmoidectomy with lavatoroplasty (n=8), Delorme's procedure (n=14)) for fear of sexual dysfunction after the abdominal approach.
CONCLUSIONS
These findings suggest that the mechanism for developing rectal prolapse in male and female may be different and that surgical treatment should be tailored to the patient.

Low Anterior Resection with Fixation of the Lateral Rectal Ligaments by EEA Stapler in Rectal Prolapse.: Kim, Byung Chun , Cho, Ji Woong , Kim, Hong Ki; J Korean Soc Coloproctol. 1999;15(2):121-129.

1,424 View
8 Download

Abstract PDF: Rectal prolapse means an abnormal descent of all layers of the rectum, with or without protrusion through the anus, and is classified into incomplete and complete rectal prolapse. Complete rectal prolapse is further divided into the first, second and third degree based on the severity. The choice of the operation for rectal prolapse is controversial. PURPOSE: The aim of this study was to evaluate the safety and effectiveness of the low anterior resection and stapled colorectal end-to-end anastomosis with fixation of the lateral rectal ligaments in rectal prolapse with redundant sigmoid colon.
METHODS
We describe our experience from January 1989 through December 1998. During this period, eight cases of complete rectal prolapse were managed at the Chunchon Sacred Heart Hospital, Hallym University. They were all men. The average age of the patients was 37 years (range, 19 to 73) and the average at onset before surgery was 19 years (range, 6 months to 33 years). At rectal examination the patients were placed in either a left supine or squatting position and were asked to strain. The duration of the follow-up assessment was ranged from one to seven years after operation. All those patients were investigated by personal interview and physical examination.
RESULTS
The most common complaint was protruding anal mass and anal bleeding. Four patients were heavy alcohol abusers. Two patients had mental retardation. Among them four patients had undergone prior anorectal procedure; two men had been treated due to hemorrhoids. The average body weight was 55 kg. The average length of the postoperative hospital stay was 16.8 days (range, 9 to 39 days). Preoperatively, there were 5 cases who had decreased anal sphincter tone. In all cases EEA stapler was used for anastomosis. The rectum was completely mobilized posteriorly and sutured to the sacrum. There was no recurrence and incontinence in all patients. The lengths of removed bowel were 15 to 20 cm (average 16.2 cm). There was no postoperative mortality, but postoperative adhesive ileus was developed in two patients, which were managed by conservative treatment.
CONCLUSIONS
In rectal prolpase, the low anterior resection of redundant sigmoid colon and stapled colorectal end-to-end anastomosis with fixation of the lateral rectal ligaments is one of the most efficient treatment.

First
Prev
Page of 1
Next
Last

Search