Application of Modified Perineal Stapled Prolapse Resection in Treatment of External Rectal Prolapse_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

1. Department of Colorectal Surgery, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China;
2. Department of Colorectal Surgery, The 6^th Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510000, Guangdong Province, China;

Corresponding author：

Keywords：

External rectal prolapse; Modified perineal stapled prolapse resection; Surgical skill; Effect

DOI：

10.7507/1007-9424.20160279

Video：

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Objective To evaluate the application of modified perineal stapled prolapse resection in treatment of external rectal prolapse, and to assess the preliminary efficacy. Methods Clinical data of 11 patients with external rectal prolapse underwent modified perineal stapled prolapse resection in The First Affiliated Hospital of Guangzhou University of Chinese Medicine between December 2013 and August 2015 were collected for retrospectively analysis. Results All patients with external rectal prolapse were performed modified perineal stapled prolapse resection with general anesthesia and (or) epidural anesthesia. The average operation time was (53.6±6.1) min (40-85 min) and the average blood loss was (35.3±10.1) mL (20-60 mL). The time of the first flatus was less than 24 h after operation, the time of the first defecation was (44.6±3.3) h (40-52 h) after operation. The average hospital stay was (9.7±1.8) d (7-12 d) and average cost was (34 635.8±1 268.8) RMB (31 796-36 212 RMB). None of them occurred serious complications such as uncontrollable anastomotic stoma bleeding, anastomotic leakage, pelvic abscess, bowel obstruction, and anastomotic straitness. All of the 11 patients were followed up for (4.7±0.8) months (3-7 months), and all patients did not suffered from recurrence and fecal incontinence during follow-up period. Conclusions The essential procedure for modified perineal stapled prolapse resection is cutting the prolapse open at 3 and 9 clock directly at the same time by linear staplers, and dissecting mesorectum before using the contour satpler. Modified perineal stapled prolapse resection is a safe and effective operation technique for the external rectal prolapse.

Citation： JIN Xin, WAN Xing-yang, LI Yu-ying, HU Feng-liang. Application of Modified Perineal Stapled Prolapse Resection in Treatment of External Rectal Prolapse. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(9): 1093-1096. doi: 10.7507/1007-9424.20160279 Copy

1.	Jacobs LK, Lin YJ, Orkin BA. The best operation for rectal prolapse. Surg Clin North Am, 1997, 77(1):49-70.
2.	Madiba TE, Baig MK, Wexner SD. Surgical management of rectal prolapse. Arch Surg, 2005, 140(1):63-73.
3.	Fang CB, Candelária Pde A, Klug WA, et al. Surgical treatment of rectal prolapse by the Delorme technique and rectopexy. Rev Assoc Med Bras, 2008, 54(2):142-145.
4.	Kimmins MH, Evetts BK, Isler J, et al. The Altemeier repair:outpatient treatment of rectal prolapse. Dis Colon Rectum, 2001, 44(4):565-570.
5.	Scherer R, Marti L, Hetzer FH. Perineal stapled prolapse resection:a new procedure for external rectal prolapse. Dis Colon Rectum, 2008, 51(11):1727-1730.
6.	Sidani SM, Goldberg SM. Midterm results after perineal stapled prolapse resection for external rectal prolapse. Dis Colon Rectum, 2013, 56(6):e327.
7.	Tschuor C, Limani P, Nocito A, et al. Perineal stapled prolapse resection for external rectal prolapse:is it worthwhile in the long-term?. Tech Coloproctol, 2013, 17(5):537-540.
8.	Mistrangelo M, Tonello P, Allaix ME, et al. Perineal stapled prolapse resection for complete external rectal prolapse:preliminary experience and literature review. Dig Surg, 2012, 29(2):87-91.
9.	申震, 刘铜军, 姜洋.经会阴切割吻合器治疗直肠脱垂8例.中华胃肠外科杂志, 2014, 17(11):1143.
10.	Ram E, Krissi H, Zbar A, et al. Perineal stapled prolapse resection (PSPR) in elderly patients for external rectal prolapse:early experience. Tech Coloproctol, 2014, 18(11):1003-1007.
11.	李东冰, 谢振年, 王芳丽, 等. STAPRE手术治疗直肠脱垂42例报道.中国普外基础与临床杂志, 2012, 19(7):774-776.
12.	Watkins BP, Landercasper J, Belzer GE, et al. Long-term follow-up of the modified Delorme procedure for rectal prolapse. Arch Surg, 2003, 138(5):498-503.
13.	Cirocco WC. The Altemeier procedure for rectal prolapse:an operation for all ages. Dis Colon Rectum, 2010, 53(12):1618-1623.
14.	Altomare DF, Binda G, Ganio E, et al. Long-term outcome of Altemeier's procedure for rectal prolapse. Dis Colon Rectum, 2009, 52(4):698-703.
15.	Sehmer D, Marti L, Wolff K, et al. Midterm results after perineal stapled prolapse resection for external rectal prolapse. Dis Colon Rectum, 2013, 56(1):91-96.
16.	Bajaj P, Wani S, Sheikh P, et al. Perineal stapled prolapse resection. Indian J Surg, 2015, 77(Suppl 3):1115-1120.
17.	Boccasanta P, Venturi M, Calabro G, et al. Stapled transanal rectal resection in solitary rectal ulcer associated with prolapse of the rectum:a prospective study. Dis Colon Rectum, 2008, 51(3):348-354.
18.	Mistrangelo M, Giono I, Arezzo A. Comments on midterm results after perineal stapled prolapse resection for external rectal prolapse. Dis Colon Rectum, 2013, 56(8):e365.
19.	Hummel B, Hardt J, Bischofberger S, et al. New kid on the block:perineal stapled prolapse resection (PSP) is it worthwhile in the long-term?. Langenbecks Arch Surg, 2016, 401(4):519-529.
20.	Romano G, Bianco F, Caggiano L. Modified perineal stapled rectal resection with contour transtar for full-thickness rectal prolapse. Colorectal Dis, 2009, 11(8):878-881.
21.	Hata F, Nishimori H, Ikeda S, et al. A simple and safe procedure to repair rectal prolapse perineally using stapling devices. Case Rep Gastroenterol, 2014, 8(1):39-43.
22.	Shin EJ. Surgical treatment of rectal prolapse. J Korean Soc Coloproctol, 2011, 27(1):5-12.
23.	Martellucci J, Talento P, Carriero A. Perineal stapled rectal resection with contour transtar. Colorectal Dis, 2010, 12(3):271-272.
24.	Hetzer FH, Roushan AH, Wolf K, et al. Functional outcome after perineal stapled prolapse resection for external rectal prolapse. BMC Surg, 2010, 10(35-36):9.
25.	国家中医药管理局医政司. 22个专业95个病种中医诊疗方案(合订本).北京:中国中医药出版社, 2010:391-414.

1. Jacobs LK, Lin YJ, Orkin BA. The best operation for rectal prolapse. Surg Clin North Am, 1997, 77(1):49-70.
2. Madiba TE, Baig MK, Wexner SD. Surgical management of rectal prolapse. Arch Surg, 2005, 140(1):63-73.
3. Fang CB, Candelária Pde A, Klug WA, et al. Surgical treatment of rectal prolapse by the Delorme technique and rectopexy. Rev Assoc Med Bras, 2008, 54(2):142-145.
4. Kimmins MH, Evetts BK, Isler J, et al. The Altemeier repair:outpatient treatment of rectal prolapse. Dis Colon Rectum, 2001, 44(4):565-570.
5. Scherer R, Marti L, Hetzer FH. Perineal stapled prolapse resection:a new procedure for external rectal prolapse. Dis Colon Rectum, 2008, 51(11):1727-1730.
6. Sidani SM, Goldberg SM. Midterm results after perineal stapled prolapse resection for external rectal prolapse. Dis Colon Rectum, 2013, 56(6):e327.
7. Tschuor C, Limani P, Nocito A, et al. Perineal stapled prolapse resection for external rectal prolapse:is it worthwhile in the long-term?. Tech Coloproctol, 2013, 17(5):537-540.
8. Mistrangelo M, Tonello P, Allaix ME, et al. Perineal stapled prolapse resection for complete external rectal prolapse:preliminary experience and literature review. Dig Surg, 2012, 29(2):87-91.
9. 申震, 刘铜军, 姜洋.经会阴切割吻合器治疗直肠脱垂8例.中华胃肠外科杂志, 2014, 17(11):1143.
10. Ram E, Krissi H, Zbar A, et al. Perineal stapled prolapse resection (PSPR) in elderly patients for external rectal prolapse:early experience. Tech Coloproctol, 2014, 18(11):1003-1007.
11. 李东冰, 谢振年, 王芳丽, 等. STAPRE手术治疗直肠脱垂42例报道.中国普外基础与临床杂志, 2012, 19(7):774-776.
12. Watkins BP, Landercasper J, Belzer GE, et al. Long-term follow-up of the modified Delorme procedure for rectal prolapse. Arch Surg, 2003, 138(5):498-503.
13. Cirocco WC. The Altemeier procedure for rectal prolapse:an operation for all ages. Dis Colon Rectum, 2010, 53(12):1618-1623.
14. Altomare DF, Binda G, Ganio E, et al. Long-term outcome of Altemeier's procedure for rectal prolapse. Dis Colon Rectum, 2009, 52(4):698-703.
15. Sehmer D, Marti L, Wolff K, et al. Midterm results after perineal stapled prolapse resection for external rectal prolapse. Dis Colon Rectum, 2013, 56(1):91-96.
16. Bajaj P, Wani S, Sheikh P, et al. Perineal stapled prolapse resection. Indian J Surg, 2015, 77(Suppl 3):1115-1120.
17. Boccasanta P, Venturi M, Calabro G, et al. Stapled transanal rectal resection in solitary rectal ulcer associated with prolapse of the rectum:a prospective study. Dis Colon Rectum, 2008, 51(3):348-354.
18. Mistrangelo M, Giono I, Arezzo A. Comments on midterm results after perineal stapled prolapse resection for external rectal prolapse. Dis Colon Rectum, 2013, 56(8):e365.
19. Hummel B, Hardt J, Bischofberger S, et al. New kid on the block:perineal stapled prolapse resection (PSP) is it worthwhile in the long-term?. Langenbecks Arch Surg, 2016, 401(4):519-529.
20. Romano G, Bianco F, Caggiano L. Modified perineal stapled rectal resection with contour transtar for full-thickness rectal prolapse. Colorectal Dis, 2009, 11(8):878-881.
21. Hata F, Nishimori H, Ikeda S, et al. A simple and safe procedure to repair rectal prolapse perineally using stapling devices. Case Rep Gastroenterol, 2014, 8(1):39-43.
22. Shin EJ. Surgical treatment of rectal prolapse. J Korean Soc Coloproctol, 2011, 27(1):5-12.
23. Martellucci J, Talento P, Carriero A. Perineal stapled rectal resection with contour transtar. Colorectal Dis, 2010, 12(3):271-272.
24. Hetzer FH, Roushan AH, Wolf K, et al. Functional outcome after perineal stapled prolapse resection for external rectal prolapse. BMC Surg, 2010, 10(35-36):9.
25. 国家中医药管理局医政司. 22个专业95个病种中医诊疗方案(合订本).北京:中国中医药出版社, 2010:391-414.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application of Modified Perineal Stapled Prolapse Resection in Treatment of External Rectal Prolapse

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