Preliminary therapeutic effect of tile shape perineal stapled prolapse resection in treatment of rectal prolapse_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 SUN Huawen , WANG Qi , YANG Houlai , WANG Qiushuang , SUN Keming

Department of Gastrointestinal Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, P. R. China;

Corresponding author：

SUN Huawen, Email: sunhuawen888@163.com

Keywords：

rectal prolapse; perineal tile shape stapled prolapse resection; therapeutic effect

DOI：

10.7507/1007-9424.201703098

Video：

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Objective To evaluate therapeutic effect of tile shape perineal stapled prolapse resection in treatment of rectal prolapse. Methods The clinical data of 31 patients with rectal prolapse underwent tile shape perineal stapled prolapse resection in the Renmin Hospital of Wuhan University from December 2013 to August 2015 were retrospectively analyzed. All the patients with rectal prolapse were performed the tile shape perineal stapled prolapse resection with general anesthesia and (or) epidural anesthesia. The prolapse was completely pulled out and then axially cut open with a linear stapler in the lithotomy position. Finally, the prolapse was resected stepwise with the curved stapler at the prolapse’s uptake. Results There were 8 males and 23 females in the 31 patients. The age was (65.8±3.2) years old. There were 14 patients with Ⅱ degree and 17 patients with Ⅲ degree prolapses. The median course was 5.8 years. The 31 patients were followed up for 0.5–7.0 months. Of 31 cases, the 24 cases were cured and 7 cases were better. It was found out that there was a significant difference between the number of axially cut open with a linear stapler and the weight of specimen (P<0.05). And there was a significant difference between the number of axially cut open with a linear stapler and the recurrence (P<0.05) too. When the number of axially cut open with a linear stapler were 4 for Ⅱ degree and 3 for Ⅲ degree, the treatment had been proved to be the highest efficacy. Conclusions Preliminary results of limited cases in this study show that tile shape perineal stapled prolapse resection is safe and effective in treatment of rectal prolapsed. Key of operation is that prolapse is completely pulled out and then axially cut open with a linear stapler at some o’clock for 2–4 points and rectal valves are formed. Prolapsed is resected stepwise with curved stapler at prolapse’s uptake. When number of axially cut open with a linear stapler are 4 for Ⅱ degree and 3 for Ⅲ degree, it could achieve the best therapeutic effect.

Citation： SUN Huawen, WANG Qi, YANG Houlai, WANG Qiushuang, SUN Keming. Preliminary therapeutic effect of tile shape perineal stapled prolapse resection in treatment of rectal prolapse. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(9): 1095-1099. doi: 10.7507/1007-9424.201703098 Copy

1.	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.
2.	金鑫, 万星阳, 李玉英, 等. 改良经会阴直肠脱垂吻合器切除术治疗完全性直肠脱垂的手术技巧. 中国普外基础与临床杂志, 2016, 23(9): 1093-1096.
3.	Scherer R. Operative therapy of external rectal prolapse with a stapler. Chirurg, 2016, 87(11): 933-937.
4.	中华中医药学会肛肠分会. 痔、肛瘘、肛裂、直肠脱垂的诊断标准(试行草案). 中国肛肠病杂志, 2004, 24(4): 42-43.
5.	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.
6.	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, 7(5): 537-540.
7.	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.
8.	Hetzer FH, Roushan AH, Wolf K, et al. Functional outcome after perineal stapled prolapse resection for external rectal prolapse. BMC Surg, 2010, 10: 9.
9.	Maternini M, Guttadauro A, Pecora N, et al. Perineal stapled prolapse resection (PSPR) for external rectal prolapse in high morbidity patients. Ann Ital Chir, 2016, 87: 476-480.
10.	Mistrangelo M, Tonello P, Brachet Contul R, et al. Perineal stapled prolapse resection for full-thickness external rectal prolapse: a multicentre prospective study. Colorectal Dis, 2016, 18(11): 1094-1100.
11.	Javed MA, Afridi FG, Artioukh DY. What operation for recurrent rectal prolapse after previous Delorme procedure? A practical reality. World J Gastrointest Surg, 2016, 8(7): 508-512.
12.	Emile SH, Elbanna H, Youssef M, et al. Laparoscopic ventral mesh rectopexy Delorme operation in management of complete rectal prolapse: a prospective randomized study. Colorectal Dis, 2017, 19(1): 50-57.
13.	Osman MM, Abd El Maksoud WM, Gaweesh YS. Delorme operation plus sphincteroplasty for complete rectal prolapse associated with traumatic fecal incontinence. J Biomed Res, 2015, 29(4): 326-331.
14.	Abdelhedi C, Frikha F, Bardaa S, et al. Altemeier operation for gangrenous rectal prolapse. S Afr J Surg, 2014, 52(3): 86-87.
15.	Ben Ameur H, Rejab H, Beyrouti MI. Altemeier operation for recurred and strangulated rectal prolapse. Indian J Surg, 2013, 75(Suppl 1): 224-226.
16.	Youssef M, Thabet W, El Nakeeb A, et al. Comparative study between Delorme operation with or without postanal repair and levateroplasty in treatment of complete rectal prolapse. Int J Surg, 2013, 11(1): 52-58.
17.	Bridoux V, Michot F, Tuech JJ. The STARR operation with the Contour 30 stapler for the treatment of obstructed defecation syndrome associated with rectocele and internal rectal prolapse. J Visc Surg, 2011, 148(5): e361-e365.
18.	Boccasanta P, Venturi M, Spennacchio M, et al. Trans-obturator colonic suspension during Altemeier operation for full-thickness rectal prolapse: preliminary results with a new technique. Colorectal Dis, 2012, 14(5): 616-622.
19.	Tsunoda A, Takahashi T, Ohta T, et al. New-onset rectoanal intussusception may not result in symptomatic improvement after laparoscopic ventral rectopexy for external rectal prolapse. Tech Coloproctol, 2016, 20(2): 101-107.
20.	Maiti S. Posterior sagittal mesh rectopexy (PSMR) and anal encirclement with polypropylene mesh for correction of complete rectal prolapse-a new application. Indian J Surg, 2015, 77(3): 244-246.

1. 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.
2. 金鑫, 万星阳, 李玉英, 等. 改良经会阴直肠脱垂吻合器切除术治疗完全性直肠脱垂的手术技巧. 中国普外基础与临床杂志, 2016, 23(9): 1093-1096.
3. Scherer R. Operative therapy of external rectal prolapse with a stapler. Chirurg, 2016, 87(11): 933-937.
4. 中华中医药学会肛肠分会. 痔、肛瘘、肛裂、直肠脱垂的诊断标准(试行草案). 中国肛肠病杂志, 2004, 24(4): 42-43.
5. 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.
6. 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, 7(5): 537-540.
7. 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.
8. Hetzer FH, Roushan AH, Wolf K, et al. Functional outcome after perineal stapled prolapse resection for external rectal prolapse. BMC Surg, 2010, 10: 9.
9. Maternini M, Guttadauro A, Pecora N, et al. Perineal stapled prolapse resection (PSPR) for external rectal prolapse in high morbidity patients. Ann Ital Chir, 2016, 87: 476-480.
10. Mistrangelo M, Tonello P, Brachet Contul R, et al. Perineal stapled prolapse resection for full-thickness external rectal prolapse: a multicentre prospective study. Colorectal Dis, 2016, 18(11): 1094-1100.
11. Javed MA, Afridi FG, Artioukh DY. What operation for recurrent rectal prolapse after previous Delorme procedure? A practical reality. World J Gastrointest Surg, 2016, 8(7): 508-512.
12. Emile SH, Elbanna H, Youssef M, et al. Laparoscopic ventral mesh rectopexy Delorme operation in management of complete rectal prolapse: a prospective randomized study. Colorectal Dis, 2017, 19(1): 50-57.
13. Osman MM, Abd El Maksoud WM, Gaweesh YS. Delorme operation plus sphincteroplasty for complete rectal prolapse associated with traumatic fecal incontinence. J Biomed Res, 2015, 29(4): 326-331.
14. Abdelhedi C, Frikha F, Bardaa S, et al. Altemeier operation for gangrenous rectal prolapse. S Afr J Surg, 2014, 52(3): 86-87.
15. Ben Ameur H, Rejab H, Beyrouti MI. Altemeier operation for recurred and strangulated rectal prolapse. Indian J Surg, 2013, 75(Suppl 1): 224-226.
16. Youssef M, Thabet W, El Nakeeb A, et al. Comparative study between Delorme operation with or without postanal repair and levateroplasty in treatment of complete rectal prolapse. Int J Surg, 2013, 11(1): 52-58.
17. Bridoux V, Michot F, Tuech JJ. The STARR operation with the Contour 30 stapler for the treatment of obstructed defecation syndrome associated with rectocele and internal rectal prolapse. J Visc Surg, 2011, 148(5): e361-e365.
18. Boccasanta P, Venturi M, Spennacchio M, et al. Trans-obturator colonic suspension during Altemeier operation for full-thickness rectal prolapse: preliminary results with a new technique. Colorectal Dis, 2012, 14(5): 616-622.
19. Tsunoda A, Takahashi T, Ohta T, et al. New-onset rectoanal intussusception may not result in symptomatic improvement after laparoscopic ventral rectopexy for external rectal prolapse. Tech Coloproctol, 2016, 20(2): 101-107.
20. Maiti S. Posterior sagittal mesh rectopexy (PSMR) and anal encirclement with polypropylene mesh for correction of complete rectal prolapse-a new application. Indian J Surg, 2015, 77(3): 244-246.

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Preliminary therapeutic effect of tile shape perineal stapled prolapse resection in treatment of rectal prolapse

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