title: Functional outcome after perineal stapled prolapse resection for external rectal prolapse.
abstract: BACKGROUND
  A new surgical technique, the Perineal Stapled Prolapse resection (PSP) for external rectal prolapse was introduced in a feasibility study in 2008. This study now presents the first results of a larger patient group with functional outcome in a mid-term follow-up.
  
  
  METHODS
  From December 2007 to April 2009 PSP was performed by the same surgeon team on patients with external rectal prolapse. The prolapse was completely pulled out and then axially cut open with a linear stapler at three and nine o'clock in lithotomy position. Finally, the prolapse was resected stepwise with the curved Contour Transtar stapler at the prolapse's uptake. Perioperative morbidity and functional outcome were prospectively measured by appropriate scores.
  
  
  RESULTS
  32 patients participated in the study; median age was 80 years (range 26-93). No intraoperative complications and 6.3% minor postoperative complications occurred. Median operation time was 30 minutes (15-65), hospital stay 5 days (2-19). Functional outcome data were available in 31 of the patients after a median follow-up of 6 months (4-22). Preoperative severe faecal incontinence disappeared postoperatively in 90% of patients with a reduction of the median Wexner score from 16 (4-20) to 1 (0-14) (P < 0.0001). No new incidence of constipation was reported.
  
  
  CONCLUSIONS
  The PSP is an elegant, fast and safe procedure, with good functional results.
  
  
  BACKGROUND
  ISRCTN68491191.
authors.affiliation: Department of Surgery, Cantonal Hospital, St. Gallen, Switzerland. franc.hetzer@kssg.ch
authors.forename: Franc H
authors.initials: FH
authors.lastname: Hetzer
authors.forename: Amir H
authors.initials: AH
authors.lastname: Roushan
authors.forename: Katja
authors.initials: K
authors.lastname: Wolf
authors.forename: Ulrich
authors.initials: U
authors.lastname: Beutner
authors.forename: Jan
authors.initials: J
authors.lastname: Borovicka
authors.forename: Jochen
authors.initials: J
authors.lastname: Lange
authors.forename: Lukas
authors.initials: L
authors.lastname: Marti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010502:Perineum / Q000601:surgery*; D012005:Rectal Prolapse / Q000601:surgery*; D017792:Surgical Stapling; D013537:Sutures; D016896:Treatment Outcome