Perineal Stapled Rectal Prolapse Resection in Elderly Patients: Long-term Follow-up

Abstract

Background: Full-thickness rectal prolapse has a significant negative impact on quality of life. The therapeutic options, specifically in elderly patients, are imperfect. Perineal stapled rectal prolapse resection is a novel operation for treating external rectal prolapse. Long-term follow-up following this procedure is lacking. In our study, we report a long-term follow-up of 30 patients, analyzing the long-term recurrence rate, morbidity, and functional outcome.

Objective: This study aimed to examine the long-term results of perineal stapled rectal resection in a population unfit for prolonged general anesthesia.

Design: This was a cohort study with a prospective follow-up.

Settings: This study was conducted at a single tertiary referral center.

Patients: Patients undergoing perineal stapled rectal resection from January 2010 to June 2013 were included.

Interventions: Perineal stapled rectal prolapse resection was performed.

Main outcome measures: The primary outcome measured was prolapse recurrence.

Results: A total of 30 patients underwent the surgical intervention. The median follow-up period was 61 months (range, 37-65). No intraoperative or postoperative complications occurred. Six patients (20%) had recurrent rectal prolapse, and continence was not achieved in any of the patients. Two patients who had recurrence underwent a redo perineal stapled rectal resection.

Limitations: This study was limited by the small cohort of selected patients.

Conclusions: Frail patients that can only endure a short procedure under regional anesthesia should be considered for perineal stapled rectal prolapse resection. The lack of mortality and morbidity, specifically in this population, along with the low long-term recurrence rates, make this a favorable surgical alternative. See Video Abstract at http://links.lww.com/DCR/A745.