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Surgical options and trends in treating rectal prolapse: long-term results in a 19-year follow-up study

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Abstract

Purpose

Many different operations have been proposed for treating rectal prolapse, with varying recurrence rates and functional outcome. The main purpose of this study was to assess long-term results of surgery for prolapse of the rectum.

Methods

We carried out a retrospective study to evaluate changing trends in surgical strategies and outcome in all patients treated in our hospital over 19 years.

Results

Ninety-three patients were operated and 30 (32%) experienced recurrence of external prolapse during a median (range) follow-up time of 82 (2–231) months. There were 37 reoperations for recurrence, bringing the total number of operations to 130.

From 1998 to 2010, laparoscopic posterior suture rectopexy was the preferred abdominal procedure with Delorme’s operation as the perineal alternative. Observed recurrence rates were 15/49 (31%) and 8/15 (53%) during a median observation time of 84 and 9 months, respectively.

From 2011 to 2017, these procedures were replaced by ventral mesh rectopexy and Altemeier’s rectosigmoidectomy. The observed recurrence rate for ventral mesh rectopexy was 3/22 (14%) during a median observation time of 29 months. The 30-day mortality rate was 3% and complication rate 14%.

Conclusions

The recurrence rates were high after all procedures, with no significant difference between posterior suture rectopexy and ventral mesh rectopexy, but the short observation time for the latter procedure is a limitation of the study. Both procedures had low complication rates, and ventral mesh rectopexy had no mortality.

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Author information

Authors and Affiliations

  1. Department of Gastrointestinal Surgery, Vestre Viken Health Trust, Drammen Hospital, 3004, Drammen, Norway

    Dagfinn Gleditsch & Wilhelm Andreas Wexels

  2. Department of Gastrointestinal Surgery, Oslo University Hospital, Oslo, Norway

    Arild Nesbakken

  3. Institute of Clinical Medicine, University of Oslo, Oslo, Norway

    Arild Nesbakken

  4. K.G. Jebsen Colorectal Cancer Research Centre, Oslo University Hospital, Oslo, Norway

    Arild Nesbakken

  5. Gastrointestinal surgery, University of Oslo, Oslo, Norway

    Arild Nesbakken

Authors
  1. Dagfinn Gleditsch
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  2. Wilhelm Andreas Wexels
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  3. Arild Nesbakken
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Contributions

Authorship D. G. and W.A. W. initiator of project, substantial involvement in data acquisition, interpretation of data, drafting of article and approval of version to be published. Accountable for all aspects of the work; A. N. Substantial contribution to conception and design, statistical analysis and interpretation of data, structuring of article, critical revision and approval of version to be published. Accountable for all aspects of the work.

Corresponding author

Correspondence to Dagfinn Gleditsch.

Ethics declarations

All procedures were performed in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Approval of ethics and study protocol was obtained from the Hospital Research Committee and the Data Protection Official for Research.

Conflict of interest

The authors declare that they have no conflict of interest.

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Gleditsch, D., Wexels, W.A. & Nesbakken, A. Surgical options and trends in treating rectal prolapse: long-term results in a 19-year follow-up study. Langenbecks Arch Surg 403, 991–998 (2018). https://doi.org/10.1007/s00423-018-1728-4

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  • DOI: https://doi.org/10.1007/s00423-018-1728-4

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