Abstract

The surgical gold standard for the treatment of hemorrhoids is hemorrhoidectomy; for anal fissure, it is internal sphincterotomy; for ulcerative colitis, restorative proctocolectomy; for anal stricture, anoplasty, etc. However, for external rectal prolapse, there is no surgical gold standard, thus necessitating a tailored approach, i.e., a surgical procedure that addresses the patient’s needs and his or her symptoms. This conclusion was confirmed in two recent papers, by Pescatori and Zbar (2009) and Brown et al. (2004a). While in those studies the number of patients differed (117 and 157, respectively), the surgical policy was the same, with essentially the same operations carried out in each center: Altemeier proctosigmoidectomy and a Delorme procedure (via a perineal route), sacral rectopexy and resection-rectopexy (via an abdominal route). All four were tailored to the particular patient, the nature of the prolapse, and the symptoms. These cases also underline the need for a specialist to be able to perform more than one procedure and to adapt each of them to both the patient and the disease.

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Copyright information

© Springer-Verlag Italia 2012

Authors and Affiliations

  • Mario Pescatori
    • 1
  1. 1.Coloproctology UnitArs Medica Hospital and La Sapienza UniversityRomeItaly

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