[Surgical therapy of rectal prolapse using rectopexy and resection. Effect of resection treatment on postoperative constipation and sphincter muscle function--a follow-up study of 112 patients].
Between 1985 and 1991, 112 patients underwent posterior abdominal rectopexy (n = 59 Ivalon sponge, n = 53 Vicryl-rectopexy) for complete rectal prolapse. The follow-up period was 3 months to 9 1/2 years. 25 patients with severe constipation and rectal prolapse were treated by rectopexy combined with colectomy (left colectomy n = 18, sigmoidectomy n = 3, ileo-sigmoidostomy n = 4). Left colectomy combined with Ivalon or Vicryl-rectopexy does not seem to increase operative and postoperative morbidity but tends to diminish constipation in 84% of patients. There were no complications attributable to bowel resection or anastomosis. Following abdominal rectopexy without resection constipation was reduced 7.5% only, the bowel function was unchanged in 69% and obstipation was improved after the operation in 23%. In the group of patients without evident constipation (n = 74) treated with synchrone resection has no benefit with regard to the new occurred constipation, recurrence prolapse and continence ability. Infection around the prosthesis developed in 1.5% in the resection group, and in 2.1% in the rectopexy alone group. The prolapse recurrence rate was 2.6%. Conclusion. Resection in conjunction with abdominal rectopexy tends to diminish postoperative constipation does not seem to increase operative morbidity, and is indicated in patients with constipation only.
Athanasiadis
S
S
Abteilung für Coloproktologie, St.-Joseph-Hospitals Duisburg-Laar.
Heiligers
J
J
Kuprian
A
A
Heumüller
L
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000379:methods; D003082:Colectomy; D003248:Constipation / Q000503:physiopathology / Q000601:surgery*; D005242:Fecal Incontinence / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D005772:Gastrointestinal Transit / Q000502:physiology; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011098:Polyglactin 910; D011183:Postoperative Complications / Q000503:physiopathology*; D012005:Rectal Prolapse / Q000503:physiopathology / Q000601:surgery*; D012007:Rectum / Q000503:physiopathology / Q000601:surgery; D012008:Recurrence; D012189:Retrospective Studies; D013526:Surgical Mesh; D013536:Suture Techniques
D011098:Polyglactin 910
Chirurgische Therapie des Rectumprolapses mittels Rectopexie und Resektion. Einfluss der Resektionsbehandlung auf postoperative Obstipation und Schliessmuskelfunktion--eine Follow-up-Studie bei 112 Patienten.