title: Stapled transanal longitudinal posterior proctectomy (STALPP) in total rectal prolapse: a 7-year experience.
abstract: BACKGROUND
  Surgical management of complete rectal prolapse is challenging. We present our results with the novel technique stapled transanal longitudinal posterior proctectomy (STALPP) in patients with complete rectal prolapse.
  
  
  METHODS
  We performed a retrospective study in two hospitals from January 2005 to December 2012. Twenty-one patients with complete rectal prolapse were included. In all patients, STALPP was performed. The study variables were operative time, intraoperative bleeding, number of cartridges used, length of rectum prolapsed through the anus, length of rectal wall resected, length of hospital stay and preoperative and postoperative Wexner continence score and manometric measurement of anal canal resting tone and squeeze pressure.
  
  
  RESULTS
  The median length of prolapsed tissue was 13 cm; the mean Wexner score in the preoperative and postoperative period was 15.95 and 4.95, respectively (p = 0.025). The mean resting tone improved from 23.3 to 32.85 mmHg postoperatively (p = 0.03), as did maximal squeeze pressure from 31 to 62.7 mmHg (p = 0.003). Median operative time was 65 min; median intraoperative bleeding was 12 ml; there was no postoperative bleeding, and no reinterventions were required. The median number of cartridges used was 4. The median length of resected wall in the right posterolateral sector was 8 and 6 cm in the left. The median length of hospital stay was 4 days, and the mean follow-up period was 2 years. No mortality was reported.
  
  
  CONCLUSIONS
  Stapled transanal longitudinal posterior proctectomy is a safe and feasible surgical alternative for patients with complete rectal prolapse.
authors.affiliation: Department of Colorectal Surgery, Specialties Hospital "Dr. Antonio Fraga Mouret" National Medical Center "La Raza", Mexican Institute of Social Security, Mexico City, Mexico, migueblas_f@hotmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Blas-Franco
authors.forename: C
authors.initials: C
authors.lastname: Valenzuela-Salazar
authors.forename: E
authors.initials: E
authors.lastname: De la Concha-Blankenagel
authors.forename: M A
authors.initials: MA
authors.lastname: Pichardo Farfan
authors.forename: P
authors.initials: P
authors.lastname: Ramírez Mendoza
authors.forename: J
authors.initials: J
authors.lastname: Hernández Figueroa
authors.forename: J
authors.initials: J
authors.lastname: Bahena Aponte
authors.forename: J
authors.initials: J
authors.lastname: de Jesus Herrera Esquivel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000503:physiopathology; D016063:Blood Loss, Surgical; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008365:Manometry; D008875:Middle Aged; D061646:Operative Time; D012005:Rectal Prolapse / Q000150:complications / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D017792:Surgical Stapling; D055815:Young Adult