COMPARISON BETWEEN LAPAROSCOPIC SUTURE RECTOPEXY AND ALTEMEIER'S PROCEDURE FOR THE MANAGEMENT OF COMPLETE RECTAL PROLAPSE- A SINGLE CENTER RETROSPECTIVE OBSERVATIONAL STUDY
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2017, Vol 4, Issue 44
Abstract
BACKGROUND Rectal prolapse is defined as protrusion of rectal wall through the anal canal. It is further classified into 3 different categories based on the extent of rectal prolapse called partial thickness (mucosal) rectal prolapse when only the mucosa is prolapsed through the anal verge, complete rectal prolapse (procidentia) involves full thickness of rectal wall prolapsing out of the anal verge and internal rectal prolapse (rectal intussusception) involves intussusception of the rectum into the anal canal without protrusion beyond the anal verge. Rectal prolapse can be partial to begin with and may or may not progress to complete rectal prolapse. The aim of our study is to analyse and compare two surgical techniques laparoscopic suture rectopexy and Altemeier’s procedure available for the management of rectal prolapse along with the outcomes of both in a single centre. MATERIALS AND METHODS The study was conducted in Department of Surgical Gastroenterology, Bangalore Medical College and Research Institute, Karnataka. It’s a retrospective observational study conducted between August 2012 and May 2016. The presenting feature, intraoperative events, postoperative course, complications and follow up were noted with regard to faecal incontinence, constipation and recurrent prolapse. RESULTS A total of 35 patients were included in this study. The male-to-female ratio was 1.7:1. The presenting feature being intermittent rectal prolapse in 31 (88%), irreducible rectal prolapse in 2 (5.7%) and 2 (5.7%) patients were operated for recurrent rectal prolapse. The presenting symptom in the patients were constipation in 14 (40%), incontinence in 5 (14.28%) and solitary rectal ulcer syndrome in 3 (8.6%). 20 patients (57.14%) underwent laparoscopic suture rectopexy with conversion to open in two patients. 15 (42.8%) patients underwent Altemeier’s procedure. The average total duration of hospital stay for patients with suture rectopexy was 3.05263 days and for Altemeier’s procedure was 5.73333 days with a statistically significant difference (p value <0.001). Morbidity in the suture rectopexy group was seen in 3 patients and in Altemeier’s group in 7 patients. No recurrence was seen in our follow up of 1 to 2 years. CONCLUSION Successful treatment of rectal prolapse is accomplished by restoration of both the anatomy and physiology of the rectum. Although, no significant differences were seen in randomised studies, the treatment should be individualised to attain satisfactory results in terms of postop bowel movements and to prevent recurrences. In our study, we observed that the patients undergoing laparoscopic suture rectopexy had higher incidence of constipation postoperatively and patients undergoing Altemeier’s had higher incidence of incontinence postoperatively.
Authors and Affiliations
Balakrishna Nanjundappa Setty, Sushrutha C Suresh, Sathish Obalanarasimhaiah, Aravinda Nirmala Kotresh, Savitha Krishnagouda Karlwad, Venugopal Hunasanahalli Giriyappa, Vinay Boppasamudra Nanjegowda, Nagesh Nayakarahalli Swamygowda
Keywords
Related Articles
- EP ID EP219938
- DOI 10.18410/jebmh/2017/534
- Views 88
- Downloads 0
PRIMARY SQUAMOUS CELL CARCINOMA OF BREAST: A RARE CASE REPORT
primary squamous carcinoma of the breast is a rare and comprises of 0.1% of carcinomas of the breast. The rarity is unmentioned in literature as it is not classified in histological types of carcinoma of the breast.
VARIOUS CLINICAL PRESENTATIONS OF CHIKUNGUNYA FEVER AND ITS OUTCOME
BACKGROUND Chikungunya is an emerging and rapidly spreading disease with varied clinical scenario/presentations, affecting largely areas colonized by the Aedes mosquito. Diagnosing, treating of Chikungunya fever and post...
ASSESSMENT OF KNOWLEDGE, AWARENESS AND ATTITUDE REGARDING FEVER AND MOSQUITO-BORNE ILLNESSES AMONG SECONDARY AND SENIOR SECONDARY SCHOOL STUDENTS OF RURAL AREA OF KANNAUJ DISTRICT IN UP, NORTH INDIA
BACKGROUND Knowledge regarding fever and mosquito-borne illnesses, and their mode of transmission, and methods of prevention, are important for the wellbeing of an individual, and disease-prevention in the community. We...
COMPARE AND CORRELATE PLASMA FIBRINOGEN, TOTAL ANTIOXIDANT CAPACITY AND BODY MASS INDEX IN PREDIABETES AND NORMAL INDIVIDUALS
Current studies indicate that the pro-inflammatory action of Fibrinogen or the activation of inflammatory sensitive proteins predicts to the increased risk of pre-diabetes. Thus objective of the project was to be evaluat...
EFFECTIVENESS OF CIPROFLOXACIN VS DOXYCYCLINE IN TREATMENT OF RHINOSCLEROMA- A CASE-CONTROL STUDY
BACKGROUND Rhinoscleroma is a chronic inflammatory condition in which deforming masses of tissue distend the nasal cavity. Klebsiella rhinoscleromatis is the causative agent. Antibiotic therapy traditionally consisted of...