Transanal Posterior Anorectoplasty of Rectal Prolapse.

, Kim, Jong Duck; , Ye, Byung Kuk; , Jo, Hong Jae; , Oh, Nahm Gun

Original Article

Journal of the Korean Society of Coloproctology 2002;18(5):269-273.

Kim, Jong Duck , Ye, Byung Kuk , Jo, Hong Jae , Oh, Nahm Gun

Department of Surgery, College of Medicine, Pusan National University, Busan, Korea. kjd0505@korea.com

Abstract

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.

Key Words: Rectal prolapse; Transanal posterior anorectoplasty; Levatorplasty