title: Perineal stapled prolapse resection for complete external rectal prolapse: preliminary experience and literature review.
abstract: OBJECTIVE
  Perineal stapled prolapse resection (PSP) for external rectal prolapse is a new surgical technique.
  
  
  METHODS
  Between April 2009 and January 2011, 5 female patients (mean age, 67 years; range, 53-76) underwent PSP for full-thickness external rectal prolapse. Patients were placed in a slight Trendelenburg position to free the pouch of Douglas from any deep enterocele. Laparoscopic control of the PSP procedure was performed to avoid injury to the bowel in one patient with anorexia. The prolapse was completely resected continuously counterclockwise using a curved Contour® Transtar™ stapler placed parallel to the dentate line. After completion of resection, the neorectum fell back into place spontaneously.
  
  
  RESULTS
  Mean operating time was 56 min (range, 40-90). No intraoperative or postoperative complications occurred. No recurrence appeared. The mean hospital stay was 4 days (range, 3-6); the mean follow-up was 6.5 months (range, 2-15). The mean Wexner fecal incontinence score was 9.2 before and 4.6 at 3 months after surgery (p = 0.010); the mean obstructed defecation syndrome score decreased from 16 to 4.75 (p < 0.001).
  
  
  CONCLUSIONS
  PSP is an easy, fast and safe procedure. Early functional results are good. Long-term results and recurrence rates need to be investigated further.
authors.affiliation: Department of Digestive and Colorectal Surgery, Centre for Minimal Invasive Surgery, Molinette Hospital, University of Turin, Turin, Italy. mistrangelo@katamail.com
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Mistrangelo
authors.forename: Paolo
authors.initials: P
authors.lastname: Tonello
authors.forename: Marco Ettore
authors.initials: ME
authors.lastname: Allaix
authors.forename: Roberto
authors.initials: R
authors.lastname: Borroni
authors.forename: Nicola
authors.initials: N
authors.lastname: Canavesio
authors.forename: Franco
authors.initials: F
authors.lastname: Corno
mesh_terms: D000368:Aged; D003113:Colonoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology; D010502:Perineum / Q000601:surgery*; D011351:Proctoscopy / Q000379:methods; D012005:Rectal Prolapse / Q000175:diagnosis / Q000601:surgery*; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index; D017792:Surgical Stapling / Q000379:methods*; D016896:Treatment Outcome