Zusammenfassung
GRUNDLAGEN: Beim Rektumvollwandprolaps ist das Standardverfahren die transabdominelle Rektopexie, meistens kombiniert mit einer distalen Kolonresektion. Aber auch transanale und perineale Verfahren kommen zur Anwendung. Bei Patienten in reduziertem Allgemeinzustand kann in Anlehnung an die Zirkularstapleranopexie nach Longo ein kurzer Rektumvollwandprolaps bis zu 4 cm alternativ durch eine doppelte Rektummanschettenresektion mittels Zirkularstapler beseitigt werden. METHODIK: Fallberichte. ERGEBNISSE: Die Technik wurde bei 3 Patientinnen durchgeführt. Intraoperativ beobachteten wir keine Komplikationen. Postoperativ kam es zu zwei Nachblutungen unter Antikoagulation. Bei einer medianen Nachbeobachtungszeit von 23 Monaten war kein Rezidiv eines Prolapses erkennbar. Der Anastomosenbereich war jeweils normal weit und gut durchblutet. SCHLUSSFOLGERUNGEN: Bei Patienten in reduziertem Allgemeinzustand mit kurzem Rektumvollwandprolaps bis zu 4 cm scheint die doppelte Rektummanschettenresektion mittels Zirkularstapler eine geeignete Option zur Beseitigung des Prolapses zu sein.
Summary
BACKGROUND: The standard procedure in the treatment of full-thickness rectal prolapse is transabdominal rectopexy, mostly in combination with a distal colon resection, although transanal and perineal procedures are also applied. Alternatively and in accordance with circular stapled anopexy following Longo's technique, a short full-thickness rectal prolapse of up to 4 cm in patients in a reduced general condition can be repaired by double rectal cuff resection using a circular stapler. METHODS: Case reports. RESULTS: This technique was performed in 3 female patients. There were no intraoperative complications. Two postoperative bleedings occurred under anticoagulation. A median follow-up period of 23 months showed no prolapse recurrence. In all cases, the anastomotic area was of normal with and well circulated. CONCLUSIONS: In patients in a reduced general condition who are suffering from short full-thickness rectal prolapse of up to 4 cm, double resection of the rectal cuff using a circular stapler seems to be a suitable option for rectal prolapse repair.
References
Duthie GS, Bartolo DC (1992) Abdominal rectopexy for rectal prolapse: a comparison of techniques. Br J Surg 79: 107–113
Abulafi AM, Sherman IW, Fiddian RV, Rothwell-Jackson RL (1990) Delorme's operation for rectal prolapse. Ann R Coll Surg Engl 72: 382–385
Agachan F, Reissman P, Pfeifer J, Weiss EG, Nogueras JJ, Wexner SD (1997) Comparison of three perineal procedures for the treatment of rectal prolapse. South Med J 90: 925–932
Longo A (1998) Treatment of hemorrhoidal disease by reduction of mucosa and hemorrhoidal prolapse with a circular stapling device: a new procedure. In: 6th World Congress of Endoscopic Surgery. Mundozzi Publishing Co, Bologna, Italy, pp 777–784
Hetzer FH, Demartines N, Handschin AE, Clavien PA (2002) Stapled vs excision hemorrhoidectomy: long-term results of a prospective randomized trial. Arch Surg 137: 337–340
Fazio VW (2000) Early promise of stapling technique for haemorrhoidectomy. Lancet 355: 768–769
Cheetham MJ, Mortensen NJ, Nystrom PO, Kamm MA, Phillips RK (2000) Persistent pain and faecal urgency after stapled haemorrhoidectomy. Lancet 356: 730–733
Ravo B, Amato A, Bianco V, Boccasanta P, Bottini C, Carriero A, Milito G, Dodi G, Mascagni D, Orsini S, Pietroletti R, Ripetti V, Tagariello GB (2002) Complications after stapled hemorrhoidectomy: can they be prevented? Tech Coloproctol 6: 83–88
Racalbuto A, Aliotta I, Corsaro G, Lanteri R, Di Cataldo A, Licata A (2004) Hemorrhoidal stapler prolapsectomy vs. Milligan-Morgan hemorrhoidectomy: a long-term randomized trial. Int J Colorectal Dis 19: 239–244
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Tarantino, I., Zerz, A., Müller-Stich, B. et al. Repair of short full-thickness rectal prolapse by transanal double circular stapled partial rectal wall resection. Eur Surg 39, 364–367 (2007). https://doi.org/10.1007/s10353-007-0367-8
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DOI: https://doi.org/10.1007/s10353-007-0367-8
Schlüsselwörter
- Transanale Rektumresektion
- Rektumprolaps
- Longo-Procedure
- Rektopexie
- PPH (Procedure fur Prolapse and Haemorrhoids)