Stapled Trans-anal Rectal Resection and Altemeir's Resection for Rectum Prolapse in Spinal Cord Injury Patients

Objective To investigate the stapled trans-anal rectal resection(STARR) and Altemeir's resection for rectum prolapse in spinal cord injury(SCI) patients.Methods Anus bowel disease of 260 SCI patients were investigated,21 cases with rectum prolapse who were invalid for nonoperative treatment chose Altemeir's resection or STARR depending on the degree of rectum prolapse.They were recorded according to International Spinal Cord Injury Bowel Function Based and Extension Set before and 12 months after operation.Results 85 SCI patients were with rectum prolapse(32.7%),21 patients complicated with constipation and mixed hemorrhoid,19 with rectal mucous membrane prolapse(7 cm),4 with rectal internal mucous intussusception,2 were completely rectum prolapse(7 cm).Rectum prolapse of Ⅰ degree was found in 13 cases,Ⅱ in 5 cases,and Ⅲ in 3 cases.Patients with Ⅰ or Ⅱ degrees rectum prolapse accepted STARR,those with Ⅲ degrees accepted Altemeir's resection.No serious complication was found.Self-report of intestinal dysfunction affecting the quality of life during the 12 months after operation significantly decreased(P0.01),so as the need of drawing out defecate with hands(P0.01),the usage of liner,plug,or antidiarrheal(P0.001).The symptom such as endless defecate feeling,abdominal distension,abdominal pain,abdominal discomfort were significantly alleviated(P0.05).Conclusion STARR and Altemeir's resection are both safe and effective operation for rectum prolapse in SCI patients.