Document Detail


Functional results of operative treatment of rectal prolapse over an 11-year period: emphasis on transabdominal approach.
MedLine Citation:
PMID:  10344689     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: A variety of surgical procedures have been developed to treat rectal prolapse, but there is still no consensus on the operation of choice. The aim of this study was to evaluate the functional results of operative treatment of rectal prolapse during an 11-year period in our department. METHODS: All patients treated for complete rectal prolapse during an 11-year period, from 1985 to 1995, in a single university hospital were included. Of the 123 patients, 22 were men, and the mean age was 59 (range, 15-88) years. The medical records of all patients were reviewed retrospectively, and a questionnaire on bowel symptoms before and after surgery was sent to all 95 living patients. RESULTS: The majority of the procedures (91 percent) were performed by abdominal approach, and the most frequently used open technique was posterior rectopexy with mesh (78 percent). Of the incontinent patients, 35 (63 percent), all those less than 40 years of age and 64 percent of those 40 years or older, were continent postoperatively (P = 0.0001) after a median follow-up of five (range, 1-72) months. According to the questionnaire, after a median follow-up of 85 (range, 16-144) months, only 38 percent of the incontinent patients in the mesh or suture group, 78 percent of patients less than 40 years of age (n = 18), and 52 percent of those 40 years or older (n = 47) claimed to be continent postoperatively. The proportion of patients with constipation was greater after the operation than preoperatively (P = 0.02) and more patients used medication for constipation after than before the operation (P = 0.0001). The overall complication rate was 15 percent, and the mortality rate was 1 percent (1/123). In the mesh or suture group there were 6 (6 percent) recurrent complete prolapses and 11 (12 percent) mucous prolapses. CONCLUSION: Posterior rectopexy with mesh gave good results in our hands. Older age and longer follow-up seem to have a negative effect on the functional outcome of the operation and on the recurrence rate.
Authors:
P T Aitola; K M Hiltunen; M J Matikainen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  42     ISSN:  0012-3706     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  1999 May 
Date Detail:
Created Date:  1999-06-10     Completed Date:  1999-06-10     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  655-60     Citation Subset:  IM    
Affiliation:
Department of Surgery, Tampere University Hospital, and Medical School, University of Tampere, Finland.
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MeSH Terms
Descriptor/Qualifier:
Abdomen / surgery
Adolescent
Adult
Aged
Aged, 80 and over
Chi-Square Distribution
Constipation / etiology
Fecal Incontinence / etiology
Female
Follow-Up Studies
Humans
Male
Middle Aged
Postoperative Complications
Questionnaires
Rectal Prolapse / complications,  physiopathology,  surgery*
Retrospective Studies
Statistics, Nonparametric
Surgical Mesh
Suture Techniques
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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