Annals of Coloproctology

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Original Article

Benign diesease & IBD,Surgical technique

Transanal rectopexy for external rectal prolapse: Shantikumar Dhondiram Chivate, Meghana Vinay Chougule, Rahul Shantikumar Chivate, Palak Harshuk Thakrar; Ann Coloproctol. 2022;38(6):415-422. Published online October 21, 2021; DOI: https://doi.org/10.3393/ac.2021.00262.0037

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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.

Citations

Citations to this article as recorded by

Systematic literature review and meta-analysis of surgical treatment of complete rectal prolapse in male patients
S. H. Emile, A. Wignakumar, N. Horesh, Z. Garoufalia, V. Strassmann, M. Boutros, S. D. Wexner
Techniques in Coloproctology.2024;[Epub] CrossRef
External rectal prolapse: more than meets the eye
M. Yiasemidou, C. Yates, E. Cooper, R. Goldacre, I. Lindsey
Techniques in Coloproctology.2023; 27(10): 783. CrossRef

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