Zeineddine Jana, Bordeianou Liliana, Krautkramer Kimberly A
Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.
Division of Gastrointestinal and Oncologic Surgery, Department of Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA.
Surg Clin North Am. 2026 Feb;106(1):77-91. doi: 10.1016/j.suc.2025.08.007. Epub 2025 Sep 12.
Rectal prolapse is a complex, multifactorial condition with significant functional and psychosocial impact. This review outlines current understanding of its pathophysiology, clinical presentation, diagnostic evaluation, and evidence-based management. Emphasis is placed on a patient-centered approach that incorporates anatomic and functional factors, as well as multidisciplinary correction of coexisting pelvic organ prolapse. Both perineal and abdominal surgical approaches offer effective treatment. Recent data support individualized operative planning based on patient characteristics, surgical risk, and surgeon expertise. Minimally invasive techniques, including laparoscopic and robotic approaches, provide favorable outcomes in appropriately selected patients and should be employed when feasible.
直肠脱垂是一种复杂的、多因素的病症，具有重大的功能和心理社会影响。本综述概述了目前对其病理生理学、临床表现、诊断评估和循证管理的认识。重点在于以患者为中心的方法，该方法纳入了解剖和功能因素，以及对并存的盆腔器官脱垂进行多学科矫正。会阴和腹部手术方法均提供有效的治疗。最近的数据支持基于患者特征、手术风险和外科医生专业知识进行个体化手术规划。包括腹腔镜和机器人手术方法在内的微创技术，在适当选择的患者中可提供良好的结果，应在可行时采用。
