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Techniques in Coloproctology

, Volume 6, Issue 2, pp 109–116 | Cite as

Perineal rectosigmoidectomy (Altemeier's procedure): a review of physiology, technique and outcome

  • A. P. Zbar
  • S. Takashima
  • T. Hasegawa
  • K. Kitabayashi
REVIEW

Abstract.

Perineal rectosigmoidectomy (Altemeier's procedure), as used for the surgical treatment of full-thickness rectal prolapse, has a long history. The physiological derangement in patients with rectal prolapse is complex, frequently showing impairment of the rectoanal inhibitory reflex, intermittent high-pressure rectal motor activity, disturbances in anorectal sampling and attendant pudendal neuropathy. There are currently few defined preoperative factors in patients presenting with rectal prolapse and fecal leakage which predict for the restoration of continence after surgery. This review describes our technique of Altemeyer's procedure and analyzes the reported results of this operation, presenting those studies which assessed postoperative continence and prolapse recurrence in particular. The lack of prospective randomized data regarding this perineal approach makes clinical interpretation difficult at the present time.

Key words Rectosigmoidectomy Altemeyer's procedure 

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Copyright information

© Springer-Verlag Italia 2002

Authors and Affiliations

  • A. P. Zbar
    • 1
  • S. Takashima
    • 2
  • T. Hasegawa
    • 2
  • K. Kitabayashi
    • 2
  1. 1.Department of Medicine and Clinical Research, Queen Elisabeth Hospital, University of West Indies, Martindales Road, St. Michael, Barbados. apzbar@hotmail.comBB
  2. 2.Kanazawa Medical University Hospital, Ishikawa Prefecuture, JapanJP

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