Transanal rectopexy for external rectal prolapse
Purpose The surgical management of patients with full-thickness rectal prolapse (FTRP) continues to remain a challenge in the laparoscopic era. This study retrospectively assesses a cohort of patients undergoing a transanal suture sacro rectopexy supported by sclerosant injection into the presacral...
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| Format: | Article |
| Language: | English |
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Korean Society of Coloproctology
2022-12-01
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| Series: | Annals of Coloproctology |
| Subjects: | |
| Online Access: | http://coloproctol.org/upload/pdf/ac-2021-00262-0037.pdf |
| _version_ | 1797962749574119424 |
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| author | Shantikumar Dhondiram Chivate Meghana Vinay Chougule Rahul Shantikumar Chivate Palak Harshuk Thakrar |
| author_facet | Shantikumar Dhondiram Chivate Meghana Vinay Chougule Rahul Shantikumar Chivate Palak Harshuk Thakrar |
| author_sort | Shantikumar Dhondiram Chivate |
| collection | DOAJ |
| description | Purpose The surgical management of patients with full-thickness rectal prolapse (FTRP) continues to remain a challenge in the laparoscopic era. This study retrospectively assesses a cohort of patients undergoing a transanal suture sacro rectopexy supported by sclerosant injection into the presacral space under ultrasound guidance. Methods Patients with FTRP underwent a sutured transrectal presacral fixation of 2/3 of the circumference of the rectum from the third sacral vertebra to the sacrococcygeal junction through a side-viewing operating proctoscope. The procedure was supplemented by ultrasound-guided injection into the retrorectal space of a 2 mL solution of sodium tetradecyl sulfate/polidocanol mixed with air. Patients were functionally assessed before and 6 months after surgery with the Agachan constipation score and the Pescatori incontinence score. Results There were 36 adult patients (26 males; the range of age, 23–92 years). The mean operative time was 27 minutes (range, 23–50 minutes) with no recorded perioperative morbidity. The median follow-up was 66 months (range, 48–84 months) with 1 (2.8%) recurrence presenting 18 months after surgery. There were 19 patients (52.8%) who presented with incontinence before surgery with 17 out of 19 (89.5%) reporting improvement in their Pescatori score (P<0.001). No patient had worsening incontinence and there were no de novo incontinence cases. Constipation scores improved in 23 out of 36 patients (63.9%) with a mean score reduction difference of 7.91 (P=0.001). Conclusion Transanal sutured sacral rectopexy with supplemental presacral sclerosant injection is safe and effective in the management of FTRP with sustained improvement in bowel function. |
| first_indexed | 2024-04-11T01:17:51Z |
| format | Article |
| id | doaj.art-df610c0103984e0488b455fee923a3bc |
| institution | Directory Open Access Journal |
| issn | 2287-9714 2287-9722 |
| language | English |
| last_indexed | 2024-04-11T01:17:51Z |
| publishDate | 2022-12-01 |
| publisher | Korean Society of Coloproctology |
| record_format | Article |
| series | Annals of Coloproctology |
| spelling | doaj.art-df610c0103984e0488b455fee923a3bc2023-01-03T23:41:46ZengKorean Society of ColoproctologyAnnals of Coloproctology2287-97142287-97222022-12-0138641542210.3393/ac.2021.00262.00371876Transanal rectopexy for external rectal prolapseShantikumar Dhondiram Chivate0Meghana Vinay Chougule1Rahul Shantikumar Chivate2Palak Harshuk Thakrar3 Department of Surgery, Jeevan Jyot Hospital, Thane, India Department of Pathology, Jeevan Jyot Hospital, Thane, India Department of Radiology, Jeevan Jyot Hospital, Thane, India Department of Radiology, Jeevan Jyot Hospital, Thane, IndiaPurpose The surgical management of patients with full-thickness rectal prolapse (FTRP) continues to remain a challenge in the laparoscopic era. This study retrospectively assesses a cohort of patients undergoing a transanal suture sacro rectopexy supported by sclerosant injection into the presacral space under ultrasound guidance. Methods Patients with FTRP underwent a sutured transrectal presacral fixation of 2/3 of the circumference of the rectum from the third sacral vertebra to the sacrococcygeal junction through a side-viewing operating proctoscope. The procedure was supplemented by ultrasound-guided injection into the retrorectal space of a 2 mL solution of sodium tetradecyl sulfate/polidocanol mixed with air. Patients were functionally assessed before and 6 months after surgery with the Agachan constipation score and the Pescatori incontinence score. Results There were 36 adult patients (26 males; the range of age, 23–92 years). The mean operative time was 27 minutes (range, 23–50 minutes) with no recorded perioperative morbidity. The median follow-up was 66 months (range, 48–84 months) with 1 (2.8%) recurrence presenting 18 months after surgery. There were 19 patients (52.8%) who presented with incontinence before surgery with 17 out of 19 (89.5%) reporting improvement in their Pescatori score (P<0.001). No patient had worsening incontinence and there were no de novo incontinence cases. Constipation scores improved in 23 out of 36 patients (63.9%) with a mean score reduction difference of 7.91 (P=0.001). Conclusion Transanal sutured sacral rectopexy with supplemental presacral sclerosant injection is safe and effective in the management of FTRP with sustained improvement in bowel function.http://coloproctol.org/upload/pdf/ac-2021-00262-0037.pdffull-thickness rectal prolapsesutured transanal sacral rectopexypresacral hemorrhage |
| spellingShingle | Shantikumar Dhondiram Chivate Meghana Vinay Chougule Rahul Shantikumar Chivate Palak Harshuk Thakrar Transanal rectopexy for external rectal prolapse Annals of Coloproctology full-thickness rectal prolapse sutured transanal sacral rectopexy presacral hemorrhage |
| title | Transanal rectopexy for external rectal prolapse |
| title_full | Transanal rectopexy for external rectal prolapse |
| title_fullStr | Transanal rectopexy for external rectal prolapse |
| title_full_unstemmed | Transanal rectopexy for external rectal prolapse |
| title_short | Transanal rectopexy for external rectal prolapse |
| title_sort | transanal rectopexy for external rectal prolapse |
| topic | full-thickness rectal prolapse sutured transanal sacral rectopexy presacral hemorrhage |
| url | http://coloproctol.org/upload/pdf/ac-2021-00262-0037.pdf |
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