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A comparative study between transanal and transabdominal approaches in treatment of complete rectal prolapse

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Mini abstract

Formulating clear guidelines for the most reliable treatment methods for complete rectal prolapse appears challenging. The authors designed this study to compare the results according to the approaches for female complete rectal prolapse and to suggest a more effective method. The transanal and abdominal groups showed differences in operating time, hospital stay, and recurrence rate. However, both groups demonstrated improvement in postoperative functional evaluation.

Purpose

There is a wide variety of surgical methods to treat rectal prolapse; however, to date, no clear agreement exists regarding the most effective surgical method. This study was designed to compare the results according to the surgical approach for complete rectal prolapse in women.

Methods

This study was conducted from March 2016 to February 2021 on female patients with rectal prolapse who underwent surgery. First, all patients were classified into mucosal and complete layer groups to confirm the difference in results between the two groups, and only complete layer prolapse patients were divided into transanal and abdominal approaches to compare parameters and functional outcomes in each group.

Results

A total of 180 patients were included, with an average age of 71.7 years and 102 complete prolapses. The complete layer group was found to have more abdominal access, longer operating time, and higher recurrence rates compared to the mucosal layer group. (p<0.001) When targeting only the complete layer patients, there were 65 patients with the transanal and 37 with the abdominal (laparoscopic) approaches. The abdominal approach group had a longer operating time and hospital stay (p<0.001, respectively) and lower recurrence rate than the transanal group (transanal vs. abdominal, 38% vs. 10.8%, p=0.003), while the Wexner constipation and incontinence scores showed improved results in both groups.

Conclusion

Although operating time and hospitalization period were shorter in the transanal group, laparoscopic abdominal surgery is a procedure that can reduce the recurrent rate for complete rectal prolapse.

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Funding

I have no source of support in the form of grants, equipment, drugs, or other means.

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Authors and Affiliations

  1. Division of Colorectal Surgery, Department of Surgery, College of Medicine, Chonnam National University Hospital, Chonnam National University, 42 Jaebong-ro, Gwangju, 61469, Republic of Korea

    Han Deok Kwak, Jun Seong Chung & Jae Kyun Ju

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  1. Han Deok Kwak
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  2. Jun Seong Chung
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  3. Jae Kyun Ju
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Contributions

Study conception and design: Han Deok Kwak. Acquisition of data: Han Deok Kwak, Jun Seong Chung and Jae Kyun Ju. Analysis and interpretation of data: Han Deok Kwak and Jae Kyun Ju. Drafting the article or revising it critically for important intellectual content: Han Deok Kwak, Jun Seong Chung and Jae Kyun Ju. Final approval of the version to be published: Han Deok Kwak and Jae Kyun Ju

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Correspondence to Jae Kyun Ju.

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Kwak, H.D., Chung, J.S. & Ju, J.K. A comparative study between transanal and transabdominal approaches in treatment of complete rectal prolapse. Int J Colorectal Dis 38, 78 (2023). https://doi.org/10.1007/s00384-023-04371-3

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  • DOI: https://doi.org/10.1007/s00384-023-04371-3

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