Document Detail


Long-term outcome of Altemeier's procedure for rectal prolapse.
MedLine Citation:
PMID:  19404077     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Altemeier's procedure is infrequently applied in European countries and because of the small number of patients treated in each center, its long-term reliability is uncertain. METHODS: Medical records of 93 patients (median age, 77 years) undergoing perineal rectosigmoidectomy associated with levatorplasty in 72 patients (78 percent) were reviewed; 65 patients (70 percent) suffered from major fecal incontinence. RESULTS: There was no postoperative mortality. Eight (8.6 percent) major complications were observed (3 pelvic hematomas, 1 anastomotic dehiscence, 1 sigmoid perforation, 1 pararectal abscess, and 2 late anal strictures), and 13 (14 percent) minor complications. At a mean follow-up of 41 (range, 12-112) months the complete recurrence rate was 18 percent (17 patients); these patients were treated with a repeat Altemeier's procedure (6 patients), Delorme's operation (1 patient), Wells' rectopexy (1 patient), postanal repair (1 patient), anal bulking agents (2 patients), and sacral nerve stimulation (2 patients). Anal manometry significantly improved postoperatively. Incontinence improved postoperatively in 30 cases (28 percent), deteriorated in 2 patients, while 4 patients developed minor incontinence. CONCLUSIONS: Perineal rectosigmoidectomy for rectal prolapse is a relatively safe and effective treatment, in particular, for frail, older patients, with a low postoperative morbidity, but the recurrence rate is not negligible and restoration of continence is unpredictable.
Authors:
Donato F Altomare; GianAndrea Binda; Ezio Ganio; Paola De Nardi; Paolo Giamundo; Mario Pescatori;
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  52     ISSN:  1530-0358     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-04-30     Completed Date:  2009-06-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  698-703     Citation Subset:  IM    
Affiliation:
Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy. altomare@clichiru.uniba.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Loss, Surgical / statistics & numerical data
Colon, Sigmoid / surgery
Comorbidity
Constipation / etiology
Digestive System Surgical Procedures / methods*
Fecal Incontinence / etiology
Female
Humans
Length of Stay
Male
Manometry
Rectal Prolapse / complications,  epidemiology,  surgery*
Rectum / surgery
Recurrence
Reoperation
Treatment Outcome
Investigator
Investigator/Affiliation:
Marcella Rinaldi / ; Aldo Infantino / ; Giuseppe Dodi / ; Nicola Tricomi / ; Diego Segre /

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


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