Surgical Management of Full-Thickness Rectal Prolapse in the Elderly Patient

  • Francesco Gabrielli
  • Angelo Guttadauro
  • Matteo Maternini
  • Nicoletta Pecora


The incidence of full-thickness rectal prolapse is 1% in patients over 65 years of age. Risk factors are multiparity, previous pelvic surgery, and neurological or psychiatric disorders. IBS, constipation, and chronic straining are comorbidity factors. Symptoms and risk of complications are indications for surgical treatment. Among abdominal operations, ventral rectopexy recently seems to offer the best long-term results. Recurrence rate less than 3–4%, a net improvement of continence, is in up to 80–90% of cases; compared with traditional rectopexies, a greater improvement in constipation and a reduced risk of postoperative constipation are observed. Perineal procedures (Altemeier’s proctosigmoidectomy) are less demanding on the patients and are still the favorite technical choice in the elderly, mostly in high-risk patients. Morbidity and mortality are low and postoperative recovery is faster. If the technique is correctly performed, there seems to be no statistically significant difference in recurrence rate between abdominal and perineal procedures. However, in the last few years, there is a new emerging trend for a wider use of laparoscopic ventral rectopexy also in geriatric low-risk patients.


Rectal prolapse Rectopexy Perineal rectosigmoidectomy 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Francesco Gabrielli
    • 1
  • Angelo Guttadauro
    • 1
  • Matteo Maternini
    • 1
  • Nicoletta Pecora
    • 1
  1. 1.Department of General SurgeryUniversity of Milan Bicocca, Zucchi HospitalMonzaItaly

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