Abstract
Rectal prolapse surgery aims at correcting the morphological problem while preserving or improving function. Both perineal and abdominal approaches (see Chap. 71) have their role. Each has its pros and cons and neither allows for an absolute guarantee. Perineal operations for rectal prolapse are the surgery of choice in emergencies, and under elective circumstances, they may be preferable in frail patients who might not tolerate an abdominal procedure and/or deep anesthesia. This chapter describes the surgical strategy and technique for perineal proctosigmoidectomy (Altemeier procedure), mucosal resection with muscular cuff plication (Delorme procedure), and the surgical legacy procedure termed the anal encirclement or Thiersch operation. The indications, contraindications, pitfalls and danger points, postoperative management, and complications are detailed.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Further Reading
American Medical Association. Current procedural terminology: CPT ®. Professional ed. Chicago: American Medical Association; 2022. https://www.ama-assn.org/practice-management/cpt.
Bordeianou L, Hicks CW, et al. Rectal prolapse: an overview of clinical features, diagnosis, and patient-specific management strategies. J Gastrointest Surg. 2014;18(5):1059–69.
Cirocco WC. The Altemeier procedure for rectal prolapse: an operation for all ages. Dis Colon Rectum. 2010;53:1618.
Corman ML. Rectal prolapse. (Internal and external), solitary rectal ulcer, descending perineum syndrome, and rectocele. In: Corman ML, editor, Bergamaschi RCM, Nicholls RJ, Fazio VW, Assoc editors. Corman’s colon and rectal surgery, 6th ed. Philadelphia, Lippincott Williams & Wilkins; 2012. pp. 644–97.
Garland B, Zutchi M. Chapter 60: Rectal prolapse. In: Steele SR, Hull TL, Read TR, Saclarides TJ, Senagore AJ, Whitlow CB, editors. The ASCRS textbook of colon and rectal surgery. 3rd ed. New York: Springer; 2016. p. 1077–90.
Glasgow SC, Birnbaum E, Kodner IJ, Fleshman JW Jr, Dietz DW. Recurrence and quality of life following perineal proctectomy for rectal prolapse. J Gastrointest Surg. 2008;12:1446.
Habr-Gama A, Jacob CE, Perez RO, Proscurshim I. Rectal prolapse: perineal approach. In: Fisher JE, editor, Jones DB, Pomposelli FB, Upchurch GR, Klimberg VS, Schwaitzberg SD, Bland KI, Assoc editors. Fischer’s mastery of surgery, 6th ed. Philadelphia, Lippincott Williams & Wilkins; 2012. pp. 1778–86.
Kaiser AM. McGraw-Hill Manual Colorectal Surgery. Access Surgery; 2009. Retrieved November 14, 2022, from https://accesssurgery.mhmedical.com/book.aspx?bookID=425.
Varma M, Rafferty J, et al. Practice parameters for the management of rectal prolapse. Dis Colon Rectum. 2011;54(11):1339–46.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2022 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Spanos, C.P., Kaiser, A.M. (2022). Perineal Operations for Rectal Prolapse. In: Scott-Conner, C.E.H., Kaiser, A.M., Nguyen, N.T., Sarpel, U., Sugg, S.L. (eds) Chassin's Operative Strategy in General Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-81415-1_82
Download citation
DOI: https://doi.org/10.1007/978-3-030-81415-1_82
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-81414-4
Online ISBN: 978-3-030-81415-1
eBook Packages: MedicineMedicine (R0)