Our Summary

This research paper discusses a new surgical procedure to treat a common postoperative complication called rectal prolapse, which can occur after radical surgery for anorectal malformations (ARMs). This condition can cause bleeding, narrowing of the rectal passage, and may sometimes require more surgery. The new procedure, known as Hemi-Circumferential Mucosal Resection (HCMR), removes part of the rectal lining without involving the muscle, thus preserving anal function.

The study retrospectively reviews patients who underwent the HCMR procedure between 2014 and 2021. The procedure was performed on 10 patients, with the median age at the time of surgery being 1.8 years. The median operation time was 46 minutes, and patients stayed in the hospital for a median of 3 days post-operation. After a median observation period of 3 years 4 months, no complications or cases of the condition recurring were observed.

The study concludes that HCMR is a safe and effective treatment for rectal prolapse after radical surgery for ARMs. It’s minimally invasive and preserves rectal muscle and function.

FAQs

  1. What is the Hemi-Circumferential Mucosal Resection (HCMR) procedure for rectal prolapse?
  2. How effective is the HCMR procedure in treating rectal prolapse post radical surgery for anorectal malformations (ARMs)?
  3. What is the median recovery time for patients who underwent the HCMR procedure?

Doctor’s Tip

A doctor may advise a patient undergoing rectal prolapse surgery to follow post-operative care instructions carefully, including avoiding heavy lifting and strenuous activity for a period of time, eating a high-fiber diet to prevent constipation, and keeping the surgical area clean to reduce the risk of infection. They may also recommend scheduling regular follow-up appointments to monitor healing and address any concerns.

Suitable For

Patients who are typically recommended for rectal prolapse surgery include those who have rectal prolapse as a result of conditions such as anorectal malformations, chronic constipation, pelvic floor dysfunction, or previous pelvic surgeries. Symptoms of rectal prolapse may include rectal bleeding, mucous discharge, a feeling of fullness or pressure in the rectum, and difficulty controlling bowel movements.

In cases where conservative treatments such as dietary changes, pelvic floor exercises, and medications have not been effective in managing rectal prolapse, surgery may be recommended. The decision to undergo surgery will depend on the severity of the prolapse, the patient’s overall health, and the potential risks and benefits of the procedure.

It is important for patients to discuss their symptoms and treatment options with a healthcare provider to determine the most appropriate course of action for their specific case of rectal prolapse.

Timeline

Before rectal prolapse surgery:

  • Patient experiences symptoms such as bleeding, narrowing of the rectal passage, and discomfort
  • Patient undergoes evaluation by a healthcare provider, including physical examination and possibly imaging tests
  • Treatment options are discussed, including conservative management or surgical intervention
  • Patient undergoes pre-operative preparation, including medical clearance and instructions for fasting

After rectal prolapse surgery:

  • Patient undergoes the HCMR procedure, which removes part of the rectal lining without involving the muscle
  • Surgery typically lasts around 46 minutes and patients stay in the hospital for about 3 days post-operation
  • Patient is monitored for any complications or recurrence of the condition during a follow-up period of several years
  • No complications or recurrences are observed, indicating the effectiveness and safety of the HCMR procedure
  • Patient experiences relief from symptoms and improved quality of life after successful treatment for rectal prolapse

What to Ask Your Doctor

Questions a patient should ask their doctor about rectal prolapse surgery:

  1. What are the potential risks and complications associated with the Hemi-Circumferential Mucosal Resection (HCMR) procedure?
  2. How long is the recovery period after the surgery and what can I expect in terms of pain management?
  3. Will I need to make any lifestyle changes or follow a specific diet after the surgery?
  4. How likely is it that the rectal prolapse will recur after the HCMR procedure?
  5. Are there any alternative treatments available for rectal prolapse that I should consider?
  6. Will I need to undergo any additional procedures or follow-up appointments after the surgery?
  7. What is the success rate of the HCMR procedure in treating rectal prolapse, based on your experience?
  8. How experienced are you in performing the HCMR procedure for rectal prolapse, and what is your success rate with this surgery?
  9. Are there any long-term effects or complications that I should be aware of after undergoing the HCMR procedure?
  10. Can you provide me with any patient testimonials or references who have undergone the HCMR procedure for rectal prolapse?

Reference

Authors: Takimoto A, Amano H, Shirota C, Sumida W, Makita S, Okamoto M, Ogata S, Takada S, Nakagawa Y, Kato D, Gohda Y, Hinoki A, Uchida H. Journal: Surg Today. 2023 May;53(5):628-632. doi: 10.1007/s00595-022-02611-7. Epub 2022 Oct 25. PMID: 36282326