title: [Clinical analysis of 31 cases with rectal prolapse undergoing modified Gant-Miwa procedure and anal encircling].
abstract: OBJECTIVE
  To evaluate the efficacy of modified Gant-Miwa procedure with anal encircling for adults with rectal prolapse.
  
  
  METHODS
  Clinical and follow-up data of 31 adult patients with rectal prolapse undergoing modified Gant-Miwa procedure with anal encircling procedure between September 2005 and January 2012 were retrospectively analyzed.
  
  
  RESULTS
  Operations were successfully performed in these 31 cases. The mean operation time was 75 (range 50-165) minutes. The mean estimated blood loss during operation was 50 (range 20-80) ml. There were no postoperative complications, such as hemorrhage, perianal abscess, anal fistula, intra-abdominal infection, or urogenital dysfunction, while only 7 patients developed urinary retention postoperatively. Rate of postoperative constipation improvement was 61.5% (8/13) and defecation difficulty improvement was 69.6% (16/23). Twenty-eight patients received anal manometry 2 months after operation and the result showed that rectal sensation threshold and rectal maximal tolerance decreased significantly, while anal resting pressure and anal squeeze pressure did not change significantly as compared to preoperative values. Six months after operation, anal function was Kirwan grade I in 22 cases and grade II in 8 cases. During a mean postoperative follow-up of 2.5 years (3 months-6.3 years), 2 of 26 patients developed recurrent prolapse.
  
  
  CONCLUSIONS
  Modified Gant-Miwa procedure with anal encircling for adults of rectal prolapse is a simple and safe procedure with low recurrence rate, minimal invasion, no serious complication and mortality, especially suitable for the elderly patients, accompanied with underlying diseases or reluctant to undergo transabdominal operation.
authors.affiliation: Department of Colorectal Surgery, The Third People's Hospital of Hangzhou, Hangzhou, China.
authors.forename: Zhong
authors.initials: Z
authors.lastname: Shen
authors.forename: Guan-gen
authors.initials: GG
authors.lastname: Yang
authors.forename: Xiu-feng
authors.initials: XF
authors.lastname: Zhang
authors.forename: Jian-ming
authors.initials: JM
authors.lastname: Qiu
authors.forename: Yan-yan
authors.initials: YY
authors.lastname: Yu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012005:Rectal Prolapse / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome