Perineal Stapled Rectal Prolapse Resection in Elderly Patients: Long-term Follow-up.

Ram, Edward; Hoffman, Aviad; Goldes, Yuri; Rosin, Danny; Horesh, Nir; Gutman, Mordechai; Edden, Yair

BACKGROUND Full-thickness rectal prolapse has a significant negative impact on quality of life. The therapeutic options, specifically in elderly patients, are imperfect. Perineal stapled rectal prolapse resection is a novel operation for treating external rectal prolapse. Long-term follow-up following this procedure is lacking. In our study, we report a long-term follow-up of 30 patients, analyzing the long-term recurrence rate, morbidity, and functional outcome. OBJECTIVE This study aimed to examine the long-term results of perineal stapled rectal resection in a population unfit for prolonged general anesthesia. DESIGN This was a cohort study with a prospective follow-up. SETTINGS This study was conducted at a single tertiary referral center. PATIENTS Patients undergoing perineal stapled rectal resection from January 2010 to June 2013 were included. INTERVENTIONS Perineal stapled rectal prolapse resection was performed. MAIN OUTCOME MEASURES The primary outcome measured was prolapse recurrence. RESULTS A total of 30 patients underwent the surgical intervention. The median follow-up period was 61 months (range, 37-65). No intraoperative or postoperative complications occurred. Six patients (20%) had recurrent rectal prolapse, and continence was not achieved in any of the patients. Two patients who had recurrence underwent a redo perineal stapled rectal resection. LIMITATIONS This study was limited by the small cohort of selected patients. CONCLUSIONS Frail patients that can only endure a short procedure under regional anesthesia should be considered for perineal stapled rectal prolapse resection. The lack of mortality and morbidity, specifically in this population, along with the low long-term recurrence rates, make this a favorable surgical alternative. See Video Abstract at http://links.lww.com/DCR/A745.