Our Summary

This research paper is about a surgical treatment for a condition called full-thickness rectal prolapse, which is when the rectum, the last part of the large intestine, slips outside the anus. This can be a really uncomfortable and distressing condition that negatively impacts a person’s quality of life. The treatment discussed in this paper is called perineal stapled rectal prolapse resection, a surgical procedure that involves stapling the rectum back in place. This is a new approach and there isn’t a lot of long-term data about how well it works over time.

In this study, the researchers observed 30 patients who underwent this surgery between 2010 and 2013. They followed up with these patients for an average of about five years to see how they were doing. They found that, for 20% of the patients, the rectal prolapse came back after the surgery. None of the patients achieved continence, meaning they still had difficulty controlling their bowel movements. Two patients who had a recurrence of prolapse had to undergo the surgery again.

The researchers conclude that this surgery may be a good option for patients who are too frail to withstand a longer, more intense operation under general anesthesia. They didn’t observe any serious complications during or after the surgery, and the rate of prolapse recurrence was relatively low. However, they caution that their study included a small number of patients, which limits the generalizability of their findings.

FAQs

  1. What is the purpose of the perineal stapled rectal prolapse resection surgery?
  2. What were the long-term results of the perineal stapled rectal resection procedure in this study?
  3. What percentage of patients experienced a recurrence of rectal prolapse after the perineal stapled rectal prolapse resection surgery according to this study?

Doctor’s Tip

A helpful tip a doctor might tell a patient about rectal prolapse surgery is to follow post-operative instructions carefully, including taking prescribed medications, keeping the surgical site clean, and avoiding strenuous activities during the recovery period. It is also important to attend follow-up appointments to monitor healing and address any concerns. Additionally, maintaining a healthy diet and lifestyle can help prevent recurrence of rectal prolapse.

Suitable For

Patients who are unfit for prolonged general anesthesia, elderly patients, and frail patients who can only endure a short procedure under regional anesthesia are typically recommended rectal prolapse surgery. These patients may benefit from perineal stapled rectal prolapse resection, as it has been shown to have low long-term recurrence rates and favorable outcomes in this population.

Timeline

Before rectal prolapse surgery:

  • Patient experiences symptoms of rectal prolapse such as feeling a bulge or protrusion from the rectum, difficulty controlling bowel movements, and pelvic pressure or discomfort.
  • Patient may undergo diagnostic tests such as a physical examination, colonoscopy, or imaging studies to confirm the diagnosis of rectal prolapse.
  • Patient may receive conservative treatments such as dietary changes, pelvic floor exercises, and medications to manage symptoms.

After rectal prolapse surgery:

  • Patient undergoes perineal stapled rectal prolapse resection, a novel surgical procedure for treating external rectal prolapse.
  • Patient is monitored for any intraoperative or postoperative complications.
  • Patient experiences a median follow-up period of 61 months to assess long-term outcomes.
  • Six patients (20%) experience recurrence of rectal prolapse, and continence is not achieved in any of the patients.
  • Two patients undergo a redo perineal stapled rectal resection for recurrent prolapse.
  • Overall, the surgery is found to have low mortality and morbidity rates, making it a favorable surgical option for frail patients who can only endure a short procedure under regional anesthesia.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with perineal stapled rectal resection surgery?
  2. What is the expected recovery time and post-operative care for this procedure?
  3. What is the success rate of perineal stapled rectal resection in treating rectal prolapse?
  4. Will this surgery improve my quality of life and alleviate my symptoms of rectal prolapse?
  5. Are there any alternative treatment options available for rectal prolapse that I should consider?
  6. How long will the effects of the surgery last, and is there a chance of recurrence in the future?
  7. What can I do to prepare for the surgery and optimize my outcomes?
  8. What is the experience and expertise of the surgical team in performing perineal stapled rectal resection?
  9. Will I need any additional follow-up appointments or tests after the surgery?
  10. Are there any lifestyle changes or modifications I should make after the surgery to support long-term success?

Reference

Authors: Ram E, Hoffman A, Goldes Y, Rosin D, Horesh N, Gutman M, Edden Y. Journal: Dis Colon Rectum. 2018 Nov;61(11):1316-1319. doi: 10.1097/DCR.0000000000001215. PMID: 30239390