Department of Surgery and Transplantation, Sheba Medical Center, Tel Hashomer, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Dis Colon Rectum. 2018 Nov;61(11):1316-1319. doi: 10.1097/DCR.0000000000001215.
Full-thickness rectal prolapse has a significant negative impact on quality of life. The therapeutic options, specifically in elderly patients, are imperfect. Perineal stapled rectal prolapse resection is a novel operation for treating external rectal prolapse. Long-term follow-up following this procedure is lacking. In our study, we report a long-term follow-up of 30 patients, analyzing the long-term recurrence rate, morbidity, and functional outcome.
This study aimed to examine the long-term results of perineal stapled rectal resection in a population unfit for prolonged general anesthesia.
This was a cohort study with a prospective follow-up.
This study was conducted at a single tertiary referral center.
Patients undergoing perineal stapled rectal resection from January 2010 to June 2013 were included.
Perineal stapled rectal prolapse resection was performed.
The primary outcome measured was prolapse recurrence.
A total of 30 patients underwent the surgical intervention. The median follow-up period was 61 months (range, 37-65). No intraoperative or postoperative complications occurred. Six patients (20%) had recurrent rectal prolapse, and continence was not achieved in any of the patients. Two patients who had recurrence underwent a redo perineal stapled rectal resection.
This study was limited by the small cohort of selected patients.
Frail patients that can only endure a short procedure under regional anesthesia should be considered for perineal stapled rectal prolapse resection. The lack of mortality and morbidity, specifically in this population, along with the low long-term recurrence rates, make this a favorable surgical alternative. See Video Abstract at http://links.lww.com/DCR/A745.
全层直肠脱垂对生活质量有显著的负面影响。治疗方法，特别是对老年患者来说，并不完善。经会阴吻合器直肠切除术是治疗直肠外脱垂的一种新手术。该手术缺乏长期随访。在我们的研究中，我们报告了 30 例患者的长期随访结果，分析了长期复发率、发病率和功能结果。
本研究旨在检查不适合长时间全身麻醉的人群经会阴吻合器直肠切除术的长期结果。
这是一项前瞻性随访的队列研究。
本研究在一家三级转诊中心进行。
纳入 2010 年 1 月至 2013 年 6 月期间接受经会阴吻合器直肠切除术的患者。
经会阴吻合器直肠切除术。
主要观察指标为脱垂复发。
共有 30 例患者接受了手术干预。中位随访时间为 61 个月（范围，37-65）。无术中或术后并发症发生。6 例（20%）患者出现直肠脱垂复发，且无 1 例患者获得控便功能。2 例复发患者行再次经会阴吻合器直肠切除术。
本研究受到所选患者小队列的限制。
对于只能在区域麻醉下耐受短时间手术的虚弱患者，应考虑行经会阴吻合器直肠切除术。该手术死亡率和发病率低，特别是在该人群中，且长期复发率低，是一种有利的手术选择。
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