Longitudinal plication--a surgical strategy for complete rectal prolapse management

Longitudinal plication--a surgical strategy for complete rectal prolapse management

Rectal prolapse is a known problem since antiquity and the cause is not fully understood. Despite the presence of more than 100 lines of treatment, none of them is ideal. Between the years of (2005-2011), thirty patients with full-thickness rectal prolapse were operated upon. Age ranged between (2-6...

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Bibliographic Details
Published in:BMC surgery Vol. 14; no. 1; p. 17
Main Authors: Qaradaghy, Seerwan H S, Hawramy, Taher A H, Nore, Beston F, Abdullah, Karwan H-A, Muhammad, Rooshad A, Zangana, Mustafa O M, Saleh, Jabar M, Ismael, Diyaree N
Format: Journal Article
Language:English
Published: England BioMed Central Ltd 24-03-2014
BioMed Central
Subjects:
Abdomen
Adolescent
Adult
Age
Aged
Ambulatory Surgical Procedures - methods
Child
Child, Preschool
Colleges & universities
Constipation
Digestive System Surgical Procedures - methods
Excretory system
Families & family life
Fecal Incontinence - etiology
Female
Follow-Up Studies
Humans
Male
Malnutrition
Middle Aged
Prevention
Rectal Prolapse - complications
Rectal Prolapse - surgery
Rectum - surgery
Recurrence
Surgery
Suture Techniques
Teaching hospitals
Treatment Outcome
Veins & arteries
Young Adult
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Summary:Rectal prolapse is a known problem since antiquity and the cause is not fully understood. Despite the presence of more than 100 lines of treatment, none of them is ideal. Between the years of (2005-2011), thirty patients with full-thickness rectal prolapse were operated upon. Age ranged between (2-65 years) with a mean of 21.5 year. Male to female ratio was (2:1). Each prolapsed rectum was repaired with longitudinal plication (LP) at two or three points accordingly using braded polyglycolic acid - absorbable 1.0 suture material. Plications started by inserting a stitch at the most proximal part of the prolapse, followed by successive similar transverse stiches continuing in a spiral fashion till the mucocutaneous junction. We used three LP in adults and two in children. All of the patients where operated upon as a day-case procedure and discharged 6 hours after the operation. In this series of patients, twenty-nine of them had complete recovery from the prolapse. Only one patient had recurrence 2 years after the operation, and the same procedure was applied successfully with uneventful post-operative period. Although twenty-three patients had fecal Incontinence, twenty-one of them regained continence after operation. This method is an easy perineal procedure, with fewer complications. It can be performed for all age groups, in an ordinary surgical unit, by an expert anorectal surgeon. We found that our procedure is simple, safe and less invasive.
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ISSN:1471-2482
1471-2482
DOI:10.1186/1471-2482-14-17