Perineal stapled prolapse resection (PSPR) for external rectal prolapse in high morbidity patients

Abstract

AIM: To demonstrated the efficacy an safety of a perineal stapled approach to treat the protrusion of the entire layer of the rectum outside the anus in high morbidity patients.

MATHERIALS OF STUDY: From February 2012 to april 2013, 7 patients (all female, mean age 74,2 years, range 48-88) were operated in our unit with perineal stapled prolapsed resection (PSPR) approach for a full thickness external rectal prolapse.

RESULTS: The duration of hospitalization was 3 days and the follow-up period was 18 months. There were no intraoperative complications and all patients had a bowel movement within 3 days of surgery. There was no mortality. None patients suffered of incontinence. Two patients (28,5%) had a recurrence and proctorragy after 18 months.

DISCUSSION: PSPR can be considered among perineal approaches for the treatment of full-thickness rectal prolapse. The reported rate of minor complications is low. No major complications have been described. Functional outcome is good, with marked improvement in both continence and constipation.

CONCLUSIONS: These results are better than those reported for other perineal procedures, although no randomized trials have yet been published. A multicenter study is needed to better evaluate the indications for and the outcome AFTER PSP.