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DOI: 10.1055/a-2131-5037
Colonoscopy-assisted percutaneous sigmoidopexy (CAPS) for complete rectal prolapse treatment: Case series
TRIAL REGISTRATION: Registration number (trial ID): UMIN000049233, Trial registry: UMIN Japan (http://www.umin.ac.jp/english/), Type of Study: Interventional Study
Abstract
Background and study aims We have previously reported on the effectiveness of colonoscopy-assisted percutaneous sigmoidopexy (CAPS) for sigmoid volvulus treatment. This study describes the CAPS application to treat complete rectal prolapse by straightening and fixing the rectum. Complete rectal prolapse is common in older women. Due to their comorbidities, management must comprise a simple, safe, and reliable surgical method not involving general anesthesia or colon resection.
Patients and methods We enrolled 13 patients in our outpatient department diagnosed with complete rectal prolapse between June 2016 and 2021. The endoscope was advanced into the anterior proximal rectal wall, straightening the intussuscepted sigmoid colon and rectum to approximate the puncture site. The fixation sites were anesthetized with 1% xylocaine, and a 2-mm skin incision was made using a scalpel. A two-shot anchor was used to fix the sigmoid colon to the abdominal wall (Olympus, Tokyo, Japan).
Results The median patient age was 88 years (range: 50–94). The median CAPS procedure time was 30 minutes (range: 20–60). In one patient, the transverse colon was accidentally punctured and interposed between the abdominal wall and sigmoid colon, requiring a laparotomy to remove the causative fixation thread and provide re-fixation. Fecal incontinence was resolved in 10 of 13 cases.
Conclusions CAPS is a quick and simple procedure. In addition, it is a treatment option for complete rectal prolapse that can be performed under local anesthesia.
Publikationsverlauf
Eingereicht: 11. Januar 2023
Angenommen nach Revision: 29. Juni 2023
Accepted Manuscript online:
17. Juli 2023
Artikel online veröffentlicht:
09. Oktober 2023
© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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References
- 1 Lowry AC, Simmang CL, Boulos P. et al. Consensus statement of definitions for anorectal physiology and rectal cancer: report of the Tripartite Consensus Conference on Definitions for Anorectal Physiology and Rectal Cancer, Washington, D.C., May 1, 1999. Dis Colon Rectum 2001; 44: 915-919 DOI: 10.1007/BF02235475. (PMID: 11496067)
- 2 Wassef R, Rothenberger DA, Goldberg SM. Rectal prolapse. Curr Probl Surg 1986; 23: 397-451 DOI: 10.1016/0011-3840(86)90011-0. (PMID: 3522112)
- 3 Tsunoda A, Takahashi T, Matsuda S. et al. Midterm functional outcome after laparoscopic ventral rectopexy for external rectal prolapse. Asian J Endosc Surg 2020; 13: 25-32 DOI: 10.1111/ases.12701. (PMID: 30920167)
- 4 Imakita T, Suzuki Y, Ohdaira H. et al. Colonoscopy-assisted percutaneous sigmoidopexy: a novel, simple, safe, and efficient treatment for inoperable sigmoid volvulus (with videos). Gastrointest Endosc 2019; 90: 514-520
- 5 D’Hoore A, Penninckx F. Laparoscopic ventral recto(colpo)pexy for rectal prolapse: surgical technique and outcome for 109 patients. Surg Endosc 2006; 20: 1919-1923 DOI: 10.1007/s00464-005-0485-y. (PMID: 17031741)
- 6 Pescatori M, Zbar AP. Tailored surgery for internal and external rectal prolapse: functional results of 268 patients operated upon by a single surgeon over a 21-year period*. Colorectal Dis 2009; 11: 410-419
- 7 Pinheiro LV, Leal RF, Coy CS. et al. Long-term outcome of perineal rectosigmoidectomy for rectal prolapse. Int J Surg 2016; 32: 78-82 DOI: 10.1016/j.ijsu.2016.06.040. (PMID: 27345263)
- 8 Altomare DF, Binda G, Ganio E. et al. Long-term outcome of Altemeier’s procedure for rectal prolapse. Dis Colon Rectum 2009; 52: 698-703 DOI: 10.1007/DCR.0b013e31819ecffe. (PMID: 19404077)
- 9 Riansuwan W, Hull TL, Bast J. et al. Comparison of perineal operations with abdominal operations for full-thickness rectal prolapse. World J Surg 2010; 34: 1116-1122
- 10 Shen Z, Yang G-G, Zhang XF. et al. Clinical analysis of 31 cases with rectal prolapse undergoing modified Gant-Miwa procedure and anal encircling. Chin J Gastrointest Surg 2013; 16: 641-644
- 11 Cirocco WC. The Altemeier procedure for rectal prolapse: an operation for all ages. Dis Colon Rectum 2010; 53: 1618-1623 DOI: 10.1007/DCR.0b013e3181f22cef. (PMID: 21178855)
- 12 Ganapathi SK, Subbiah R, Rudramurthy S. et al. Laparoscopic posterior rectopexy for complete rectal prolapse: is it the ideal procedure for males?. J Minim Access Surg 2022; 18: 295-301 DOI: 10.4103/jmas.JMAS_323_20. (PMID: 35313438)
- 13 D'Hoore A, Cadoni R, Penninckx F. Long-term outcome of laparoscopic ventral rectopexy for total rectal prolapse. Br J Surg 2004; 91: 1500-1505 DOI: 10.1002/bjs.4779. (PMID: 15499644)
- 14 Smedberg J, Graf W, Pekkari K. et al. Comparison of four surgical approaches for rectal prolapse: multicentre randomized clinical trial. BJS Open 2022; 6: zrab140 DOI: 10.1093/bjsopen/zrab140. (PMID: 35045155)