Abstract
Backgroundrectal prolapse can cause bleeding and fecal incontinence that affects the life quality of patients. The treatment of external rectal prolapse is surgical. There are many procedures (abdominal or perineal) that can be used depending on the severity of the condition and patient tolerability for operation. In this study, a simple safe procedure is used for the treatment of the rectal prolapse in old, fragile and comorbid patients who cannot withstand the major surgeries and the risk of long-duration anesthesia.Methodsfrom December 2016 to July 2019, 36 elderly comorbid patients with rectal prolapse were involved in this study which is performed in the GIT surgery unit of Zagazig University Hospital. A modified linear stapler resection technique is used for the rectal prolapse. Postoperative follow up was done for one year to evaluate the functional outcome, operative time, hospital stay duration and complications.Resultthis study was conducted on 36 patients; The median age was 75 years (range 48–95). The postoperative complication rate was 11.1%. The median operative time was 25 min and 4 days for the hospital stay. Fecal incontinence improved in more than 90% of patients and constipation disappeared in 66% of total constipating patients.ConclusionThe modified perineal linear stapler resection for external rectal prolapse is a good, easy, rapid treatment for elderly comorbid patients with good functional outcomes.
Highlights
The perineal stapled prolapse resection (PSP) was used for the first time in 2008
Preoperative bimanual examination was done for rectal prolapse to rule out enterocele or cystocele and this was confirmed by MRI
Evaluation of the new modification of PSP depends on the functional results of the surgery including incontinence, constipation, and pudendal nerve injury
Summary
The perineal stapled prolapse resection (PSP) was used for the first time in 2008. It showed good promising results regarding functional outcome and complications [1]. The shorter operating time of (PSP) is the main advantage over other techniques [2]. The other advantages of (PSP) are large median circumference with less postoperative capacity reduction and less anastomotic stenosis in comparison to circular stapler used in the modified perineal rectosigmiodectomy [3]. The higher cost of (PSP) is the main obstacle for usage so in this study (PSP) was done at a lower cost by using a simple modification (only one reloadable linear stapler with 2 cartridges)
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