What are the surgical options for recurrent rectal prolapse - a retrospective single-center experience

Abstract

Objectives: Most authors highlight the absence of international guidelines in the treatment of recurrent rectal prolapse (RRP), even among coloproctologists. However, it is clearly indicated that Delorme’s or Thiersch’s surgeries are reserved for older and fragile patients, so on the other hand, transabdominal surgeries are dedicated to generally fitter patients. The aim of the study is evaluation of surgical treatment effects for recurrent rectal prolapse (RRP)Methods: The study group comprised of 20 female and 2 male patients aged from 37 to 92 years (subjected to treatment last 20 years). Initial treatment consisted of abdominal mesh rectopexy (n=4), perineal sigmorectal resection (n=9), Delorme’s technique (n=3), Thiersch’s anal banding (n=3), colpoperineoplasty (n=2), anterior sigmorectal resection (n=1). The relapses occured between 2 to 30 months. Results: Reoperations consisted of abdominal without (n=8) or with resection rectopexy (n=3), perineal sigmorectal resection (n=5), Delorme’s technique (n=1), total pelvic floor repair (n=4), perineoplasty (n=1). 11 patients (50%) were completely cured. 6 patients developed subsequent RRP. They were successfully reoperated (2 rectopexies, 2 perineocolporectopexies, 2 perineal sigmorectal resections). Conclusions: Abdominal mesh rectopexy is the most effective method for RP and RRP treatment. Total pelvic floor repair may prevent RRP. Perineal rectosigmoid resection results of less permament effects of RRP repair.