2020Annals of Medicine and SurgeryOpen access

Modified perineal linear stapler resection for external rectal prolapse

Osama H. Khalil, Tamer A. A. M. Habeeb, Bassem Sieda

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Abstract

BACKGROUND: rectal prolapse can cause bleeding and fecal incontinence that affects the life quality of patients. The treatment of external rectal prolapse is surgical. There are many procedures (abdominal or perineal) that can be used depending on the severity of the condition and patient tolerability for operation. In this study, a simple safe procedure is used for the treatment of the rectal prolapse in old, fragile and comorbid patients who cannot withstand the major surgeries and the risk of long-duration anesthesia. METHODS: from December 2016 to July 2019, 36 elderly comorbid patients with rectal prolapse were involved in this study which is performed in the GIT surgery unit of Zagazig University Hospital. A modified linear stapler resection technique is used for the rectal prolapse. Postoperative follow up was done for one year to evaluate the functional outcome, operative time, hospital stay duration and complications. RESULT: this study was conducted on 36 patients; The median age was 75 years (range 48-95). The postoperative complication rate was 11.1%. The median operative time was 25 min and 4 days for the hospital stay. Fecal incontinence improved in more than 90% of patients and constipation disappeared in 66% of total constipating patients. CONCLUSION: The modified perineal linear stapler resection for external rectal prolapse is a good, easy, rapid treatment for elderly comorbid patients with good functional outcomes.

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What this paper is about

BACKGROUND: rectal prolapse can cause bleeding and fecal incontinence that affects the life quality of patients. The treatment of external rectal prolapse is surgical. There are many procedures (abdominal or perineal) that can be used depending on the severity of the condition and patient tolerability for operation. In this study, a simple safe procedure is used for the treatment of the rectal prolapse in old, fragile and comorbid patients who cannot withstand the major surgeries and the risk of long-duration anesthesia. METHODS: from December 2016 to July 2019, 36 elderly comorbid patients with rectal prolapse were involved in this study which is performed in the GIT surgery unit of Zagazig University Hospital. A modified linear stapler resection technique is used for the rectal prolapse. Postoperative follow up was done for one year to evaluate the functional outcome, operative time, hospital stay duration and complications. RESULT: this study was conducted on 36 patients; The median age was 75 years (range 48-95). The postoperative complication rate was 11.1%. The median operative time was 25 min and 4 days for the hospital stay. Fecal incontinence improved in more than 90% of patients and constipation disappeared in 66% of total constipating patients. CONCLUSION: The modified perineal linear stapler resection for external rectal prolapse is a good, easy, rapid treatment for elderly comorbid patients with good functional outcomes.

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Available abstract

BACKGROUND: rectal prolapse can cause bleeding and fecal incontinence that affects the life quality of patients. The treatment of external rectal prolapse is surgical. There are many procedures (abdominal or perineal) that can be used depending on the severity of the condition and patient tolerability for operation. In this study, a simple safe procedure is used for the treatment of the rectal prolapse in old, fragile and comorbid patients who cannot withstand the major surgeries and the risk of long-duration anesthesia. METHODS: from December 2016 to July 2019, 36 elderly comorbid patients with rectal prolapse were involved in this study which is performed in the GIT surgery unit of Zagazig University Hospital. A modified linear stapler resection technique is used for the rectal prolapse. Postoperative follow up was done for one year to evaluate the functional outcome, operative time, hospital stay duration and complications. RESULT: this study was conducted on 36 patients; The median age was 75 years (range 48-95). The postoperative complication rate was 11.1%. The median operative time was 25 min and 4 days for the hospital stay. Fecal incontinence improved in more than 90% of patients and constipation disappeared in 66% of total constipating patients. CONCLUSION: The modified perineal linear stapler resection for external rectal prolapse is a good, easy, rapid treatment for elderly comorbid patients with good functional outcomes.

Key concepts: Medicine, Rectal prolapse, Surgery, Constipation, Fecal incontinence, Complication, Tolerability, Rectum

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