Our Summary

This study looked at the medical records of patients who had a specific type of surgery (LAARP) for a certain type of birth defect affecting the rectum and anus. The researchers wanted to understand the characteristics of patients who experienced rectal prolapse (a condition where the rectum slips out of place) after this surgery, why this might happen, and how it might affect their bowel function afterwards.

Out of the 49 patients in the study, 29 experienced rectal prolapse after surgery. There was no significant difference in factors such as gender, the specific type of birth defect, any associated spine anomalies, the time the surgery took, or post-surgery bowel function at different ages between those who had rectal prolapse and those who didn’t. However, they found that the surgery was performed at a younger age in patients who didn’t experience rectal prolapse.

For patients who had prolapse, over half developed it before a follow-up procedure to close a colostomy, and about a third of those who had surgery to fix the prolapse needed additional surgeries. In addition, the study found no significant relationship between any muscular abnormalities seen in pre-surgery imaging and the chance of rectal prolapse after surgery.

The researchers concluded that while rectal prolapse is common after this type of surgery, performing the surgery at a younger age might help prevent it.

FAQs

  1. What is the LAARP surgery for rectal prolapse?
  2. What factors were found to affect the occurrence of rectal prolapse after the surgery?
  3. How does the age at which the surgery is performed affect the chance of rectal prolapse post-surgery?

Doctor’s Tip

A doctor might advise a patient undergoing rectal prolapse surgery to follow post-operative care instructions carefully, including avoiding heavy lifting and strenuous activity for a certain period of time. They may also recommend maintaining a high-fiber diet and staying hydrated to prevent constipation, which can put strain on the rectum and potentially lead to prolapse. It is important to follow up with your doctor regularly to monitor for any signs of complications and address any concerns promptly.

Suitable For

Overall, patients who are recommended rectal prolapse surgery are those who have experienced rectal prolapse, typically as a result of certain medical conditions or birth defects affecting the rectum and anus. Additionally, patients who have not responded well to conservative treatments for rectal prolapse may also be recommended for surgery. It is important for patients to consult with their healthcare provider to determine if rectal prolapse surgery is the most appropriate treatment option for their individual case.

Timeline

Overall, the timeline for a patient before and after rectal prolapse surgery may look something like this:

  1. Pre-surgery: Patient is diagnosed with a rectal prolapse and undergoes pre-operative evaluations to determine the appropriate surgical procedure. The patient may experience symptoms such as rectal bleeding, pain, and a sensation of a bulge or protrusion in the rectal area.

  2. Surgery: The patient undergoes rectal prolapse surgery, in this case LAARP, to correct the prolapse and restore normal rectal function. The surgery may involve repositioning and securing the rectum in place, as well as repairing any rectal or anal muscles that may be contributing to the prolapse.

  3. Post-surgery: In the immediate post-operative period, the patient may experience pain, discomfort, and temporary changes in bowel function as they recover from the surgery. The patient will be closely monitored by medical professionals to ensure proper healing and to address any complications that may arise.

  4. Follow-up: The patient may require additional follow-up procedures or surgeries to address any complications or to further improve rectal function. It is important for the patient to follow their healthcare provider’s instructions for post-operative care and to attend all recommended follow-up appointments.

  5. Long-term outcomes: The patient may experience improvements in their rectal function and quality of life after rectal prolapse surgery. However, as seen in the study mentioned above, some patients may still experience complications such as rectal prolapse, which may require further intervention. It is important for patients to maintain regular follow-up with their healthcare providers to monitor their rectal health and address any issues that may arise.

What to Ask Your Doctor

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

  1. What are the potential risks and complications of rectal prolapse surgery?
  2. How likely am I to experience rectal prolapse after this surgery?
  3. Are there any specific factors that may increase my risk of developing rectal prolapse after surgery?
  4. How can I minimize my risk of experiencing rectal prolapse after surgery?
  5. What is the typical recovery process like after rectal prolapse surgery?
  6. Will I need any additional surgeries or procedures after the initial surgery to fix rectal prolapse?
  7. Are there any long-term effects on bowel function that I should be aware of after rectal prolapse surgery?
  8. How will my age at the time of surgery impact my risk of developing rectal prolapse?
  9. Are there any specific imaging tests or evaluations that can help determine my risk of rectal prolapse after surgery?
  10. What is the success rate of rectal prolapse surgery in preventing or fixing rectal prolapse in patients with my specific condition?

Reference

Authors: Ishimaru T, Hosokawa T, Kawashima H, Hayashi K, Takayama S, Omata K, Sanmoto Y, Gohara T. Journal: J Laparoendosc Adv Surg Tech A. 2020 Dec;30(12):1277-1281. doi: 10.1089/lap.2020.0609. Epub 2020 Oct 21. PMID: 33085916