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Trends in the treatment of rectal prolapse: a population analysis

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Rectal prolapse is a common condition, with conflicting opinions on optimal surgical management. Existing literature is predominantly composed of case series, with a dearth of evidence demonstrating current, real-world practice. This study investigated recent national trends in management of rectal prolapse in the Republic of Ireland (ROI).

Methods

This population analysis used a national database to identify patients admitted in the ROI primarily for the management of rectal prolapse, as defined by the International Classification of Diseases, 10th Revision (ICD-10). Demographics, procedures, comorbidities, and outcomes were obtained for patients admitted from 2005 to 2015 inclusive.

Results

There were 2648 admissions with a primary diagnosis of rectal prolapse; 39.3% underwent surgical correction. The majority were treated with either a perineal resection (47.2%) or an abdominal rectopexy ± resection (45.1%). The population-adjusted rate of operative intervention increased over the study period, from 25 to 42 per million (p < 0.001), with no change in the mean age of patients over time (p = 0.229). The application of a laparoscopic approach increased over time (p = 0.001). Patients undergoing an abdominal rectopexy were younger than those undergoing a perineal procedure (64.1 ± 17.3 versus 75.2 ± 15.5 years, p < 0.001) despite having a similar Charlson Comorbidity Index (p = 0.097). The mortality rate for elective repair was 0.2%.

Conclusions

Despite the popularization of ventral mesh rectopexy over the study period, perineal resection Delorme’s procedure remains the most common procedure employed for the correction of rectal prolapse in the ROI, with specific approach determined by age.

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Authors and Affiliations

  1. Department of Colorectal Surgery, Beaumont Hospital, Dublin 9, Ireland

    A. C. Rogers, N. McCawley, J. Deasy, D. A. McNamara & J. P. Burke

  2. Department of Colorectal Surgery, St Vincent’s University Hospital, Elm Park, Dublin 4, Ireland

    A. M. Hanly

  3. Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin 2, Ireland

    D. A. McNamara & J. P. Burke

Authors
  1. A. C. Rogers
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  2. N. McCawley
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  3. A. M. Hanly
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  4. J. Deasy
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  5. D. A. McNamara
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  6. J. P. Burke
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All authors meet the criteria for authorship as per ICMJE recommendations.

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Correspondence to J. P. Burke.

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The authors declare that they have no conflict of interest.

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Rogers, A.C., McCawley, N., Hanly, A.M. et al. Trends in the treatment of rectal prolapse: a population analysis. Int J Colorectal Dis 33, 459–465 (2018). https://doi.org/10.1007/s00384-018-2971-4

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  • DOI: https://doi.org/10.1007/s00384-018-2971-4

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