ABSTRACT
Rectal prolapse remains an uncommon disorder, the optimal surgical treatment of which has eluded surgeons for centuries. Recently, there has been resurgent interest in the use of perineal approaches for its management. Compared with transabdominal approaches, perineal approaches have long been felt to be less technically demanding for the surgeon and to be less stressful on the patient, permitting an expedient and uneventful recovery for even the highest-risk patient. Reports of improved recurrence rates, amelioration of symptoms of fecal incontinence, and lack of exacerbation of constipation and sexual dysfunction have made perineal approaches to rectal prolapse attractive. Perineal approaches currently in use include perineal rectosigmoidectomy (Altemeier procedure), mucosal sleeve resection (Delorme procedure), and anal encirclement (Thiersch procedure). This article describes these procedures as they are used to treat rectal prolapse and provides an update of the most recent results reported with these procedures.
KEYWORD
Procidentia - rectal prolapse - Altemeier - Delorme - Thiersch - perineal rectosigmoidectomy