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Clin Colon Rectal Surg 2001; 14(3): 243-252
DOI: 10.1055/s-2001-16552
Copyright © 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Perineal Approaches for Rectal Prolapse

Julio Faria, Alan G. Thorson
  • Section of Colon and Rectal Surgery, Creighton University School of Medicine, Omaha, NB
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Publikationsdatum:
22. August 2001 (online)

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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

REFERENCES

  • 1 Mikulicz J. Zur operativen behandlung des prolapsus recti et coli invaginati.  Arch Klin Chir . 1889;  38 74-97
    PubMedSuche in Google Scholar
  • 2 Altemeier W A, Culbertson W R, Schowengerdt C, Hunt J. Nineteen years' experience with the one-stage perineal repair of rectal prolapse.  Ann Surg . 1971;  173 993-1006
    PubMedSuche in Google Scholar
  • 3 Prasad M L, Pearl R K, Abcarian H. Perineal proctectomy, posterior rectopexy, and postanal levator repair for the treatment of rectal prolapse.  Dis Colon Rectum . 1986;  29 547-552
    CrossrefPubMedSuche in Google Scholar
  • 4 Yoshioka K, Hyland G, Keighley M R. Anorectal function after abdominal rectopexy: parameters of predictive value in identifying return of continence.  Br J Surg . 1989;  76 64-68
    PubMedSuche in Google Scholar
  • 5 Deen K I, Grant E, Billingham C, Keighley M R. Abdominal resection rectopexy with pelvic floor repair versus perineal rectosigmoidectomy and pelvic floor repair for full-thickness rectal prolapse.  Br J Surg . 1994;  81 302-304
    CrossrefPubMedSuche in Google Scholar
  • 6 Agachan F, Pfeifer J, Joo J S. Results of perineal procedures for the treatment of rectal prolapse.  Am Surg . 1997;  63 9-12
    PubMedSuche in Google Scholar
  • 7 Kim D S, Tsang C B, Wong W D. Complete rectal prolapse: evolution of management and results.  Dis Colon Rectum . 1999;  42 460-466
    CrossrefPubMedSuche in Google Scholar
  • 8 Delorme R. Sur le traitement des prolapsus du rectum totaux pour l'excision de la muqueuse rectale ou rectocolique.  Bull Mem Soc Chir Paris . 1900;  26 498-499
    PubMedSuche in Google Scholar
  • 9 Uhlig B E, Sullivan E S. The modified Delorme operation: its place in surgical treatment for massive rectal prolapse.  Dis Colon Rectum . 1979;  22 513-521
    PubMedSuche in Google Scholar
  • 10 Nay H R, Blair C R. Perineal surgical repair of rectal prolapse.  Am J Surg . 1972;  123 577-579
    CrossrefPubMedSuche in Google Scholar
  • 11 Moskalenko V W. Modification of Delorme's resection of rectal mucosa for prolapse of the rectum.  Int Surg . 1973;  58 192-194
    PubMedSuche in Google Scholar
  • 12 Lechaux J P, Lechaux D, Perez M. Results of Delorme's procedure for rectal prolapse. Advantages of a modified technique.  Dis Colon Rectum . 1995;  38 301-307
    CrossrefPubMedSuche in Google Scholar
  • 13 Plusa S M, Charig J A, Balaji V. Physiological changes after Delorme's procedure for full-thickness rectal prolapse.  Br J Surg . 1995;  82 1475-1478
    PubMedSuche in Google Scholar
  • 14 Chow P K, Ho Y H. Abdominal resection rectopexy versus Delorme's procedure for rectal prolapse: comparison of clinical and physiological outcomes.  Int J Colorectal Dis . 1996;  11 201-202
    CrossrefPubMedSuche in Google Scholar
  • 15 Penninckx F, D'Hoore A, Sohier S, Kerremans R. Abdominal resection rectopexy versus Delorme's procedure for rectal prolapse: a predictable outcome.  Int J Colorectal Dis . 1997;  12 49-50
    CrossrefPubMedSuche in Google Scholar
  • 16 Senapati A, Nicholls R J, Thomson J P, Phillips R K. Results of Delorme's procedure for rectal prolapse.  Dis Colon Rectum . 1994;  37 456-460
    CrossrefPubMedSuche in Google Scholar
  • 17 Pescatori M, Interisano A, Stolfi V M, Zoffoli M. Delorme's operation and sphincteroplasty for rectal prolapse and fecal incontinence.  Int J Colorectal Dis . 1998;  13 223-227
    CrossrefPubMedSuche in Google Scholar
  • 18 Terrell R V. Experience with Thiersch wire in rectal prolapse.  AORN J . 1968;  8 72-76
    PubMedSuche in Google Scholar
  • 19 Wilson E. Thiersch's operation.  Aust NZ J Surg . 1969;  38 239-243
    PubMedSuche in Google Scholar
  • 20 Hopkinson B R, Hardman J. Silicone rubber perianal suture for rectal prolapse.  Proc R Soc Med . 1973;  66 1095-1098
    PubMedSuche in Google Scholar
  • 21 Jackaman F R, Francis J N, Hopkinson B R. Silicone rubber band treatment of rectal prolapse.  Ann R Coll Surg Engl . 1980;  62 386-387
    PubMedSuche in Google Scholar
  • 22 Sainio A P, Halme L E, Husa A I. Anal encirclement with polypropylene mesh for rectal prolapse and incontinence.  Dis Colon Rectum . 1991;  34 905-908
    PubMedSuche in Google Scholar
  • 23 Labow S B, Hoexter B, Moseson M D. Modification of silastic sling repair for rectal procidentia and anal incontinence.  Dis Colon Rectum . 1985;  28 684-685
    PubMedSuche in Google Scholar
  • 24 Thorlakson R H. A modification of the Thiersch procedure for rectal prolapse using polyester tape.  Dis Colon Rectum . 1982;  25 57-58
    PubMedSuche in Google Scholar
  • 25 Poole G VJ, Pennell T C, Myers R T, Hightower F. Modified Thiersch operation for rectal prolapse. Technique and results.  Am Surg . 1985;  51 226-229
    PubMedSuche in Google Scholar
  • 26 Rye B A, Seidelin C, Dueholm S. Perineal progressive myonecrosis following Thiersch's operation for rectal prolapse.  Ann Chir Gynaecol . 1987;  76 136-137
    PubMedSuche in Google Scholar
  • 27 Pikarsky A J, Joo J S, Wexner S D. Recurrent rectal prolapse: what is the next good option?.  Dis Colon Rectum . 2000;  43 1273-1276
    PubMedSuche in Google Scholar
  • 28 Fengler S A, Pearl R K, Prasad M L. Management of recurrent rectal prolapse.  Dis Colon Rectum . 1997;  40 832-834
    CrossrefPubMedSuche in Google Scholar
  • 29 Hool G R, Hull T L, Fazio V W. Surgical treatment of recurrent complete rectal prolapse: a thirty-year experience.  Dis Colon Rectum . 1997;  40 270-272
    CrossrefPubMedSuche in Google Scholar
  • 30 Friedman R, Muggia S M, Freund H R. Experience with the one-stage perineal repair of rectal prolapse.  Dis Colon Rectum . 1983;  26 789-791
    CrossrefPubMedSuche in Google Scholar
  • 31 Gopal K A, Amshel A L, Shonberg I L, Eftaiha M. Rectal procidentia in elderly and debilitated patients. Experience with the Altemeier procedure.  Dis Colon Rectum . 1984;  27 376-381
    PubMedSuche in Google Scholar
  • 32 Watts J D, Rothenberger D A, Buls J G. The management of procidentia: 30 years' experience.  Dis Colon Rectum . 1985;  28 96-102
    CrossrefPubMedSuche in Google Scholar
  • 33 Finlay I G, Aitchison M. Perineal excision of the rectum for prolapse in the elderly.  Br J Surg . 1991;  78 687-689
    PubMedSuche in Google Scholar
  • 34 Thorne M C, Polglase A L. Perineal proctectomy for rectal prolapse in elderly and debilitated patients.  Aust NZ J Surg . 1992;  62 791-794
    PubMedSuche in Google Scholar
  • 35 Williams J G, Rothenberger D A, Madoff R D, Goldberg S M. Treatment of rectal prolapse in the elderly by perineal rectosigmoidectomy.  Dis Colon Rectum . 1992;  35 830-834
    CrossrefPubMedSuche in Google Scholar
  • 36 Johansen O B, Wexner S D, Daniel N. Perineal rectosigmoidectomy in the elderly.  Dis Colon Rectum . 1993;  36 767-772
    CrossrefPubMedSuche in Google Scholar
  • 37 Ramanujam P S, Venkatesh K S, Fietz M J. Perineal excision of rectal procidentia in elderly high-risk patients. A ten-year experience.  Dis Colon Rectum . 1994;  37 1027-1030
    CrossrefPubMedSuche in Google Scholar
  • 38 Agachan F, Reissman P, Pfeifer J. Comparison of three perineal procedures for the treatment of rectal prolapse.  South Med J . 1997;  90 925-932
    CrossrefPubMedSuche in Google Scholar
  • 39 Yoshioka K, Ogunbiyi O A, Keighley M R. Pouch perineal rectosigmoidectomy gives better functional results than conventional rectosigmoidectomy in elderly patients with rectal prolapse.  Br J Surg . 1998;  85 1525-1526
    CrossrefPubMedSuche in Google Scholar
  • 40 Christiansen J, Kirkegaard P. Delorme's operation for complete rectal prolapse.  Br J Surg . 1981;  68 537-538
    PubMedSuche in Google Scholar
  • 41 Gundersen A L, Cogbill T H, Landercasper J. Reappraisal of Delorme's procedure for rectal prolapse.  Dis Colon Rectum . 1985;  28 721-724
    PubMedSuche in Google Scholar
  • 42 Monson J R, Jones N A, Vowden P, Brennan T G. Delorme's operation: the first choice in complete rectal prolapse?.  Ann R Coll Surg Engl . 1986;  68 143-146
    PubMedSuche in Google Scholar
  • 43 Houry S, Lechaux J P, Huguier M, Molkhou J M. Treatment of rectal prolapse by Delorme's operation.  Int J Colorectal Dis . 1987;  2 149-152
    CrossrefPubMedSuche in Google Scholar
  • 44 Abulafi A M, Sherman I W, Fiddian R V, Rothwell J R. Delorme's operation for rectal prolapse.  Ann R Coll Surg Engl . 1990;  72 382-385
    PubMedSuche in Google Scholar
  • 45 Graf W, Ejerblad S, Krog M. Delorme's operation for rectal prolapse in elderly or unfit patients.  Eur J Surg . 1992;  158 555-557
    PubMedSuche in Google Scholar
  • 46 White S, Stitz R W. Rectal prolapse: Delorme or Ripstein repair.  Aust NZ J Surg . 1992;  62 193-195
    PubMedSuche in Google Scholar
  • 47 Oliver G C, Vachon D, Eisenstat T E. Delorme's procedure for complete rectal prolapse in severely debilitated patients. An analysis of 41 cases.  Dis Colon Rectum . 1994;  37 461-467
    CrossrefPubMedSuche in Google Scholar
  • 48 Tobin S A, Scott I H. Delorme operation for rectal prolapse.  Br J Surg . 1994;  81 1681-1684
    CrossrefPubMedSuche in Google Scholar
  • 49 Kling K M, Rongione A J, Evans B, McFadden D W. The Delorme procedure: a useful operation for complicated rectal prolapse in the elderly.  Am Surg . 1996;  62 857-860
    PubMedSuche in Google Scholar
  • 50 Pescatori M. Anal continence after surgery for rectal prolapse.  Dis Colon Rectum . 1998;  41 405
    PubMedSuche in Google Scholar
  • 51 Yakut M, Kaymakcioglu N, Simsek A. Surgical treatment of rectal prolapse. A retrospective analysis of 94 cases.  Int Surg . 1998;  83 53-55
    PubMedSuche in Google Scholar
  • 52 Watts A M, Thompson M R. Evaluation of Delorme's procedure as a treatment for full-thickness rectal prolapse.  Br J Surg . 2000;  87 218-222
    CrossrefPubMedSuche in Google Scholar
  • 58 Dietzen C D, Pemberton J H. Perineal approaches for the treatment of complete rectal prolapse.  Neth J Surg . 1989;  41 140-144
    PubMedSuche in Google Scholar
  • 53 Labow S, Rubin R J, Hoexter B, Salvati E P. Perineal repair of rectal procidentia with an elastic fabric sling.  Dis Colon Rectum . 1980;  23 467-469
    CrossrefPubMedSuche in Google Scholar
  • 54 Hunt T M, Fraser I A, Maybury N K. Treatment of rectal prolapse by sphincteric support using silastic rods.  Br J Surg . 1985;  72 491-492
    PubMedSuche in Google Scholar
  • 55 Larach S W, Vazquez B. Modified Thiersch procedure with silastic mesh implant: a simple solution for fecal incontinence and severe prolapse.  South Med J . 1986;  79 307-309
    PubMedSuche in Google Scholar
  • 56 Earnshaw J J, Hopkinson B R. Late results of silicone rubber perianal suture for rectal prolapse.  Dis Colon Rectum . 1987;  30 86-88
    PubMedSuche in Google Scholar
  • 57 Khanduja K S, Hardy-TG J, Aguilar P S. A new silicone-prosthesis in the modified Thiersch operation.  Dis Colon Rectum . 1988;  31 380-383
    PubMedSuche in Google Scholar