title: Perineal stapled prolapse resection for full-thickness external rectal prolapse: a multicentre prospective study.
abstract: OBJECTIVE
  Many different surgical techniques have been reported for the surgical treatment of full-thickness external rectal prolapse. Perianal stapled prolapse resection (PSP) is a relatively newly reported technique for full thickness external rectal prolapse. The aim of this prospective multicentre study was to evaluate the results of this procedure.
  
  
  METHODS
  Consecutive patients who underwent a PSP resection for full-thickness external rectal prolapse at five centres were recruited to the study. Median operating time, hospital stay, complications, recurrence and functional results according to the Wexner Incontinence Scale and obstructive defaecation syndrome score were recorded.
  
  
  RESULTS
  There were 27 patients treated by PSP. The median Wexner incontinence score improved from 10 presurgery to 5 after surgery (P < 0.001); the median obstructed defaecation syndrome score improved from 12 presurgery to 5 (range 4-10) after surgery (P < 0.001). A laparoscopically assisted procedure was performed in three patients (11.1%). The median number of cartridges used was six (range four to nine). The median operating time was 48 min. Early complications occurred in six patients (22.2%) and late complications in two (7.4%). The median length of hospital stay was 5 days. The recurrence rate at a median follow-up of 30.3 months was 14.8%.
  
  
  CONCLUSIONS
  PSP appears to be an easy, fast and safe procedure. Early functional results are good. The recurrence rate compares favourably with other perineal procedures like the Delorme or the Altemeier operations. Long-term functional results need to be investigated further.
authors.affiliation: Department of Surgical Sciences, Centre of Minimal Invasive Surgery, University of Turin, Turin, Italy. mistrangelo@katamail.com.
authors.forename: M
authors.initials: M
authors.lastname: Mistrangelo
authors.affiliation: Department of Surgery, Koelliker Hospital, Turin, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Tonello
authors.affiliation: Department of Surgery, Aosta Hospital, Aosta, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Brachet Contul
authors.affiliation: Department of Surgery, Martini Hospital, Turin, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Arnone
authors.affiliation: Nuclear Medicine Department, University of Turin, Turin, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Passera
authors.affiliation: Department of Surgical Sciences, Centre of Minimal Invasive Surgery, University of Turin, Turin, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Grasso
authors.affiliation: Department of Surgical Sciences, Centre of Minimal Invasive Surgery, University of Turin, Turin, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Rapetti
authors.affiliation: Department of Surgery, Koelliker Hospital, Turin, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Borroni
authors.affiliation: Department of Surgery, Biella Hospital, Biella, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Pozzo
authors.affiliation: Department of Surgery, Aosta Hospital, Aosta, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Roveroni
authors.affiliation: Department of Surgical Sciences, Centre of Minimal Invasive Surgery, University of Turin, Turin, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Morino
authors.affiliation: Department of Surgery, Biella Hospital, Biella, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Perinotti
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003248:Constipation / Q000209:etiology / Q000601:surgery; D003672:Defecation / Q000502:physiology; D005242:Fecal Incontinence / Q000209:etiology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010502:Perineum / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011184:Postoperative Period; D057234:Preoperative Period; D011446:Prospective Studies; D012005:Rectal Prolapse / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D012008:Recurrence; D012720:Severity of Illness Index; D017792:Surgical Stapling / Q000379:methods*; D016896:Treatment Outcome
keywords: Contour® Transtar™; Rectal prolapse; perineal approach; perineal stapled prolapse resection