EXternal Pelvic REctal SuSpension (Express procedure) for rectal intussusception, with and without rectocele repair

Autor: S. M. Scott, Pasquale Giordano, A. Huang, Marion Allison, J. N. R. Frye, Lee S. Dvorkin, Peter J. Lunniss, N. S. Williams
Rok vydání: 2005
Předmět:
Zdroj: British Journal of Surgery. 92:598-604
ISSN: 1365-2168
0007-1323
Popis: Background The results of conventional treatment for rectal intussusception and rectocele are unpredictable. The aim was to develop a less invasive surgical approach and to evaluate outcome in selected patients. Methods Seventeen patients (13 women; median age 47 (range 20–67) years) with rectal evacuatory dysfunction and rectal intussusception, 13 of whom had a rectocele, were selected. The intussusception was corrected by external pelvic suspension of the rectum, using collagen strips attached to the rectal wall and pubis. The rectocele was repaired with a collagen patch. Patients were assessed before and 6 months after surgery by symptom and quality of life questionnaires, anorectal physiological investigation and proctography, and were followed up for a median of 12 months. Results Sepsis requiring exploration occurred in two patients but there was no extrusion or need to remove the collagen. Of the 15 patients assessed after surgery, total symptom scores were significantly decreased (P < 0·001) and quality of life scores improved (P < 0·001). Proctographically, the degree of intussusception was improved in ten patients; six patients had normal postoperative proctograms. The rectocele was reduced in size in all patients, and was not demonstrable in eight. Conclusion An effective procedure for rectal intussusception and rectocele has been developed in a selected group of patients with marked evacuatory symptoms.
Databáze: OpenAIRE
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