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CC BY 4.0 · Journal of Coloproctology 2024; 44(04): e249-e252
DOI: 10.1055/s-0044-1800891
Original Article

Altemeier Procedure for Complete Rectal Prolapse: An Operation for all Ages and its Long-Term Functional Outcomes

Thamarai Kannan Murugesan 
1   Department of Surgical Gastroenterology, Madurai Medical College, Madurai, Tamil Nadu, India
,
Karthikeyan Srinivasan
1   Department of Surgical Gastroenterology, Madurai Medical College, Madurai, Tamil Nadu, India
,
Sastha Ahanatha Pillai
1   Department of Surgical Gastroenterology, Madurai Medical College, Madurai, Tamil Nadu, India
,
Villalan Ramasamy
1   Department of Surgical Gastroenterology, Madurai Medical College, Madurai, Tamil Nadu, India
,
Krishna Prasad Chowdary Mikkilineni Bharani
1   Department of Surgical Gastroenterology, Madurai Medical College, Madurai, Tamil Nadu, India
,
Venkkatesh Sreepathi
1   Department of Surgical Gastroenterology, Madurai Medical College, Madurai, Tamil Nadu, India
,
Padmanabhan Subbareddiar
1   Department of Surgical Gastroenterology, Madurai Medical College, Madurai, Tamil Nadu, India
› Institutsangaben Funding Not applicable
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Abstract

Objective The aim of this study is to evaluate the long-term functional outcomes in patients treated by Altemeier's procedure for complete rectal prolapse.

Methods Records of 40 patients who underwent Altemeier's procedure for complete rectal prolapse between January 2013 to June 2023 were analyzed. The median duration of post operative follow-up was 48 months (ranges- 6 months to 10 years). Postoperatively, fecal incontinence, constipation and recurrence were analyzed.

Results The median age was 45 (13-75) years. The male-to-female ratio was 1.4:1. Among forty patients, five patients had recurrent rectal prolapse. Out of forty, nine patients underwent emergency Altemeier's procedure. The median time taken for the procedure was 120 (80-155) minutes. The median postoperative length of hospital stay was 9 days. Three patients (7.5%) had Grade I anastomosis leak. All patients subsequently developed anastomotic stricture and were managed with periodic anal dilatation. There was no mortality. Postoperatively, constipation reduced from 25% to 7.5% and fecal incontinence reduced from 37.5% to 10%. There was no recurrence in our study.

Conclusion The Altemeier procedure is a safe and effective procedure in both elderly and young patients presenting with complete rectal prolapse. It was associated with minimal morbidity and good long-term functional outcomes.

Keywords

Altemeier procedure - complete rectal prolapse - perineal rectosigmoidectomy - levatorplasty - fecal incontinence - constipation

Author's Contributions

All authors contributed to the study's conception and design. Padmanabhan S proposed the study. Thamarai Kannan M and Karthikeyan S performed research and wrote the first draft. Thamarai Kannan M, Venkkatesh S, and Krishna Prasad Chowdary Mikkilineni Bharani collected and analyzed the data. Sastha A and Villalan R contributed to the design and interpretation of the study. Sastha A, Padmanabhan S, and Karthikeyan S contributed to further drafts. All authors read and approved the final manuscript.


Data Availability Statement

There is no data availability statement.




Publikationsverlauf

Eingereicht: 11. August 2024

Angenommen: 24. Oktober 2024

Artikel online veröffentlicht:
18. Dezember 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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