title: Longitudinal plication--a surgical strategy for complete rectal prolapse management.
abstract: BACKGROUND
  Rectal prolapse is a known problem since antiquity and the cause is not fully understood. Despite the presence of more than 100 lines of treatment, none of them is ideal.
  
  
  METHODS
  Between the years of (2005-2011), thirty patients with full-thickness rectal prolapse were operated upon. Age ranged between (2-65 years) with a mean of 21.5 year. Male to female ratio was (2:1). Each prolapsed rectum was repaired with longitudinal plication (LP) at two or three points accordingly using braded polyglycolic acid - absorbable 1.0 suture material. Plications started by inserting a stitch at the most proximal part of the prolapse, followed by successive similar transverse stiches continuing in a spiral fashion till the mucocutaneous junction. We used three LP in adults and two in children. All of the patients where operated upon as a day-case procedure and discharged 6 hours after the operation.
  
  
  RESULTS
  In this series of patients, twenty-nine of them had complete recovery from the prolapse. Only one patient had recurrence 2 years after the operation, and the same procedure was applied successfully with uneventful post-operative period. Although twenty-three patients had fecal Incontinence, twenty-one of them regained continence after operation.
  
  
  CONCLUSIONS
  This method is an easy perineal procedure, with fewer complications. It can be performed for all age groups, in an ordinary surgical unit, by an expert anorectal surgeon. We found that our procedure is simple, safe and less invasive.
authors.affiliation: Department of General Surgery, School of Medicine, Faculty of Medical Sciences, University of Sulaimani, Sulaimani, Kurdistan Region, Iraq. quaradaghi@gmail.com.
authors.forename: Seerwan H S
authors.initials: SH
authors.lastname: Qaradaghy
authors.forename: Taher A H
authors.initials: TA
authors.lastname: Hawramy
authors.forename: Beston F
authors.initials: BF
authors.lastname: Nore
authors.forename: Karwan H-A
authors.initials: KH
authors.lastname: Abdullah
authors.forename: Rooshad A
authors.initials: RA
authors.lastname: Muhammad
authors.forename: Mustafa O M
authors.initials: MO
authors.lastname: Zangana
authors.forename: Jabar M
authors.initials: JM
authors.lastname: Saleh
authors.forename: Diyaree N
authors.initials: DN
authors.lastname: Ismael
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012005:Rectal Prolapse / Q000150:complications / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D012008:Recurrence; D013536:Suture Techniques; D016896:Treatment Outcome; D055815:Young Adult