Rectal prolapse: a historical perspective.

Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Mayfield Heights, Ohio, USA.
Current problems in surgery (Impact Factor: 1.42). 09/2009; 46(8):602-716. DOI: 10.1067/j.cpsurg.2009.03.006
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    ABSTRACT: Laparoscopic resection rectopexy (LRR) and laparoscopic ventral rectopexy (LVR) are favored for the treatment for rectal prolapse (RP) in the USA and Europe, respectively. This study aims to compare these two surgical techniques. All patients who underwent LRR because of RP between January 2000 and January 2012 at Cleveland Clinic Florida (Weston, FL, USA) were identified, and all relevant characteristics were entered in a database. This same analysis was also conducted for all patients who underwent LVR in the Meander Medical Center (Amersfoort, the Netherlands) between January 2004 and January 2012. These two cohorts were retrospectively compared with regard to complications, functional results and recurrence. Twenty-eight patients (all female, mean age 50.1 years) were included in the LRR cohort at a mean follow-up of 57 (range 2-140; standard deviation (SD) ± 41.2) months. The LVR group consisted of 40 patients (36 females and 4 males) with a mean age of 67.0 years and a mean follow-up of 42 (range 2-82; SD ± 23.8) months. A significant reduction in constipation was observed in both cohorts after surgery: 57 versus 21 % after LRR and 55 versus 23 % after LVR (both P < 0.05). The incidence of incontinence also significantly decreased in both groups: 15 % after LVR (55 % before surgery) and 4 % after LRR (61 % before surgery). Direct comparison of these two techniques showed a trend to significance (P = 0.09). Significantly, more complications occurred after LRR (n = 9: 1 major, 8 minor) then after LVR (n = 3: 2 major, 1 minor) (P < 0.05). Both LVR and LRR are effective for the treatment for RP. Although both techniques offer significant improvements in functional symptoms, continence may be better after LRR. However, LRR also had a higher complication rate then did LVR.
    Techniques in Coloproctology 02/2014; · 1.54 Impact Factor
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    ABSTRACT: Purpose of the study The rectal prolapse is a frequent affection of the young child and represents a motive for consultation regularly met in paediatrics. The purpose of this article is to review the coverage of child rectal prolapse, by promoting the perirectal injection with a sclerosing product. Patients and methods Retrospective study concerning 15 cases of primitive children rectal prolapses observed handled between 2002 and 2009. The treatment undergone by all the patients in this series was essentially based on the injection of sclerosing product under the mucous membrane, after failure of the medical treatment. Results The remote results were estimated after 2 years. No second recurrence was reported. The cure was obtained in 100% of the cases, without any complication. Conclusion The approach of this study is to show the utility of under mucous membrane injections of sclerosing product in the treatment of primitive rectal prolapse of the child to obtain a complete cure.
    Journal de Pédiatrie et de Puériculture 06/2013; 26(3):157–160.
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    ABSTRACT: Rectal prolapse is a known problem since antiquity and the cause is not fully understood. Despite the presence of more than 100 lines of treatment, none of them is ideal. Between the years of (2005-2011), thirty patients with full-thickness rectal prolapse were operated upon. Age ranged between (2-65 years) with a mean of 21.5 year. Male to female ratio was (2:1). Each prolapsed rectum was repaired with longitudinal plication (LP) at two or three points accordingly using braded polyglycolic acid - absorbable 1.0 suture material. Plications started by inserting a stitch at the most proximal part of the prolapse, followed by successive similar transverse stiches continuing in a spiral fashion till the mucocutaneous junction. We used three LP in adults and two in children. All of the patients where operated upon as a day-case procedure and discharged 6 hours after the operation. In this series of patients, twenty-nine of them had complete recovery from the prolapse. Only one patient had recurrence 2 years after operation, and the same procedure was applied successfully with uneventful post-operative period. Although twenty-three patients had fecal incontinence and twenty-one of them regained continence after operation. This method is an easy perineal procedure, with fewer complications. It can be performed for all age groups, in an ordinary surgical unit, by an expert anorectal surgeon. We found that our procedure is simple, safe and less invasive.
    BMC Surgery 03/2014; 14(1):17. · 1.24 Impact Factor