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At least 343 records · Page 19Linked to original sources
PubMed2006

Obsessive-compulsive disorder and rectal prolapse.

A 47-year-old woman with a long-standing history of obsessive-compulsive disorder relating to dirt and germs is presented. Her fear of developing bowel cancer led her to manually evacuate faeces from her rectum five times a day and to a resultant rectal prolapse. Treatment involved prolonged graduated exposure to the patient's feared contaminants and ritual avoidance. After 5 months of inpatient therapy, the patient reported a subjective 70% improvement in her symptoms. As her obsessive-compulsive disorder symptoms improved, the patient's rectal prolapse disappeared.

Behavior Therapy↗
PubMedDate not supplied

Surgical treatment of rectal prolapse. A retrospective analysis of 94 cases.

METHODS: A retrospective analysis evaluating 94 patients who underwent posterior rectopexy in 48 patients (51%), resection with or without rectopexy in 19 patients (20%) and Delorme's procedure in 27 patients (29%) was carried out for rectal prolapse in the last 15 years. The surgical procedures are described in detail. Postoperative evaluation was possible in all patients and mean observation time was 3.2 years. RESULTS: Mortality rate was zero. Recurrence was seen in 4 cases (4.2%), only after Delorme's procedures. The proportion of continent patients increased from 69.2% preoperatively to 91.6% postoperatively. Defecation difficulties and incomplete evacuation did not change beneficially after the surgery. Important postoperative complications, retrograde ejaculation and impotence were seen in 5 male patients (17.2) after posterior rectopexy, and were a major cause of dissatisfaction. CONCLUSIONS: In conclusion, Delorme's procedure, posterior rectopexy and resection procedures are effective surgical operations for treatment of rectal prolapse but extensive pelvic dissection during the posterior rectopexy may create serious sexual problems in male patients.

Adult↗
PubMed1990

Délorme's operation for rectal prolapse.

Between 1981 and 1988 inclusive, 22 patients with full-thickness rectal prolapse presenting to two surgeons in this hospital were treated using the Délorme operation. There was no mortality and morbidity was minimal. Twenty-one patients (95.5%) were cured of prolapse and 19 patients (86.4%) had normal anal sphincter function after the operation.

Adult↗
PubMed2002

Cauterization-plication operation in the treatment of complete rectal prolapse.

The current communication presents a simple technique for treatment of complete rectal prolapse (CRP). The study included 28 patients presenting with CRP (mean age, 36.4 years; 4 children 2-12 years; 17 female and 11 males). Fourteen patients had fecal incontinence. With the patient under general anesthesia in lithotomy position, the prolapsed rectum was pulled outside the anal canal, the mucosa was cauterized in vertical lines and the exposed muscle layer was plicated by 2/0 coated Vicryl sutures. Posterior levatorplasty was done in 14 adult patients in whom the length of prolapsed segment was more than 10 cm and who were incontinent due to a wide levator hiatus. The postoperative follow up was 31.6+/-14.8 months (mean+/-SD). Five had postoperative mucosal prolapse and one had recurrence 3 months of operation. Mucosal plication was performed for the five patients and the operation was redone for the recurrent patient. Fecal impaction, stricture and fistula formation were not encountered. The technique is simple, easy and with minimal complications.

Adolescent↗
PubMed1994

[Abdominal rectopexy (Orr-Loygue) in rectal prolapse: celioscopic approach or conventional surgery].

One of the treatment modalities for rectal prolapse is abdominal rectopexy, a comparison of the Orr-Loygue procedure, performed by laparotomy and by laparoscopy was done. From June 1981 and May 1993, 31 females and 3 males, with an average of age of 58.8 were operated. Twelve patients were operated by laparoscopy (group I) and 22 patients by laparotomy (group II). Two patients (16.7%) in group I were converted to a laparotomy due in one to operative hemorrhage and in the other to adhesions. Seven patients in group I and 18 in group II had had previous abdominal surgery. Average operative time was 2.56 hours and 2.25 hours for groups I and II respectively. A reduction in post operative hospital stay (5 vs 8.3 days) as well as in intramuscular analgesic requirements (5.5 vs. 14.1 doses) was observed in group I vs. group II respectively. Time to oral intake and cessation of intravenous fluids were also reduced in group I compared to group II (1.0 vs. 3.9 days and 2 vs. 5.8 days respectively). No mortality and minimal morbidity was observed in both groups. No recurrence of prolapse was noted in either group with an average of 12.6 mouths follow-up (2.8 to 17 months). We concluded that rectopexy by laparoscopy is technically feasible and has undeniable advantages over laparotomy.

Adult↗
PubMedDate not supplied

A new surgical procedure for treatment of complete rectal prolapse: preliminary report.

A new technique is reported for treatment of massive rectal prolapse, combining: mobilization of the rectum, colorectal fixation to the promontory and sacrum, "hammock-like" peritoneal autosuspension and obliteration of Douglas's pouch. The technique was successfully performed in six cases, with a follow-up ranging from one to six years; anal continence was satisfactory in four and fair in two.

Aged↗
PubMed1989

Rectal prolapse caused by blunt abdominal trauma.

We describe a case of incarcerated rectal prolapse caused by blunt abdominal trauma. Emergency treatment consisted of manual reduction with the patient under general anesthesia, proctosigmoidoscopy, and peritoneal lavage. Subsequent definitive surgical therapy was then performed after bowel preparation and consisted of anterior resection of the sigmoid colon with posterior (sacral) rectopexy.

Abdominal Injuries↗
PubMed1999

Management of rectal prolapse in children: Ekehorn's rectosacropexy.

Although surgical intervention is occasionally required for rectal prolapse (RP), there is both vagueness as to the indications for surgery and confusion as to the technique that should be used for children who need surgical treatment. Using Ekehorn's transanal suture rectosacropexy technique, 56 children with RP were treated surgically between 1987 and 1998 at our hospital. There were 36 boys and 20 girls, the average age was 4.5 years, and the duration of the recurrent prolapse prior to admission ranged from 3 to 8 months. The technique consists of simply inserting one "U"-shaped suture through the rectal ampulla and tying the strands of the suture outside at the level of the sacrococcygeal junction. In this series, follow-up periods ranged from 1 to 10 years and there were no recurrences. We believe that surgical indications for RP need to be defined more clearly and that Ekehorn's technique offers a simple and effective method for the surgical treatment of complete RP in children.

Adolescent↗
PubMed1981

Perineal rectopexy for rectal prolapse.

Twenty-two female patients (mean age 75 years) with complete rectal prolapse have been treated by operative fixation of the rectum to the sacrum using a perineal approach. There has been no operative mortality, sepsis or serious morbidity. Recurrence of complete prolapse has been seen once only within a month of operation and was due to inadequate operative fixation. The other 21 patients have been followed for up to 4 years. This type of operation may be the treatment of choice in the elderly patient considered unfit for major abdominal surgery but further experience is required before it can be advocated in other groups of patients.

Adult↗
PubMed1975

Symposium: Procidentia of the rectum: teflon sling repair of rectal prolapse, Lahey Clinic experience.

The Teflon-sling method of repair of rectal prolapse in the Lahey Clinic experience has proved to be one of no mortality and low morbidity, with a recurrence rate of 7.3 per cent over an average follow-up period of nearly four years. Bowel management and incontinence are problems inherent in the pathogenesis of the problem and, though improved, necessitate long-term patient re-education and physiotherapy. More than 85 per cent of the patients were satisfied with the results of the procedure.

Adult↗
PubMed1996

[Total rectal prolapse in children. Diagnostic and therapeutic trends. Statistics apropos of 52 cases].

Rectal procidentia represents classically only 2% of rectal prolapse in children. This rarity is more apparent than real, because peritoneographies showing the excess of migration of the rectogenital pouch, allows to diagnose more often this pathology. The normal trend of this anomaly of the infant and the young child even if it could be serious with strangulation is usually a spontaneous healing. Accordingly therapeutic indications should be cautious. Surgery is only indicated in confirmed or complicated forms. After analysis of the statistic of 52 observations, the modified Lockhart-Mummery is our prefered procedure. It needs a short and simple surgery and the results appear satisfactory.

Age Factors↗
PubMedDate not supplied

Closed rectopexy with transanal resection for complete rectal prolapse in adults.

Many techniques have been described for repair of complete rectal prolapse in adults. The results of abdominal approaches are superior to those of perineal approaches, but they carry the risks of major abdominal surgery. Twenty-seven patients (15 females and 12 males) were included in this study, with a mean age of 46 years. Nine of these patients had fecal incontinence. The operation can be performed under spinal or general anesthesia. The operation involves transanal resection of the redundant part of the rectum followed by rectopexy through small postanal incisions. The mean follow-up period was 24 months. One patient developed infection in one stab incision 6 months after the operation. Two patients had hematoma formation, which were managed conservatively. During the 2-year period of follow-up, no recurrence was observed in any of our patients. Fecal incontinence improved in the nine incontinent patients. The technique is simple, easy, and less invasive with good results and less morbidity and is not associated with serious complications.

Adult↗
PubMed1976

A parasacral approach to rectal prolapse.

A posterior parasacral approach is introduced for management of third-degree rectal prolapse. Anterior approximation of the levator musculature and posterior fixation of the rectum are accomplished readily through the York Mason approach.

Humans↗
PubMed1983

[Clinical classification of rectal prolapse].

Having analyzed the experience with examination and treatment of 182 patients with rectal prolapse the authors are presenting a clinical classification including the main criteria of the disease: stage of prolapse, degree of incompetence of the anal sphincter, phase of compensation of the pelvic fundus muscles. On the basis of the classification proposed the adequate method of treatment of such patients can be chosen. In 97% of patients the prolapse of the rectum have been liquidated, in 92,5% of them the function of its closing apparatus have been completely recovered.

Adolescent↗
PubMed1983

The Roscoe Graham-Goligher procedure in the treatment of complete rectal prolapse.

From April 1972 to December 1980 31 patients underwent repair of a complete rectal prolapse by various techniques. In 17 patients the Roscoe Graham-Goligher procedure was performed and 15 patients were reviewed to assess results. A complete recurrence was found in four patients (27%), two had a mucosal prolapse (13%). Fecal continence improved in four patients (27%). We no longer believe there is a place for this procedure since other rectal fixation techniques are easier to perform and give better results.

Adolescent↗
PubMed2000

[Surgical treatment of total rectal prolapse: Delorme's technique].

Rectal total prolapsus is a cause of a permanent disablement more founded in old women. Many pathogenetic hypotheses are made up to date time, many surgical treatments were proposed for the treatments of this disease: through perineal, abdominal or combined way. The results are different, of course, in a short and a long time, whether in the matter of relapse of the prolapse, or in morbidity in connection to surgical treatment and his sequences. After a review of the most frequent techniques now in use, the Authors report their experience on 6 patients operated from 6 January 1988 to June 1993, giving reasons for their preference to Delorme's operation through perineal way.

Adult↗
PubMed2005

Laparoscopic resection rectopexy for rectal prolapse.

INTRODUCTION: The laparoscopic approach in suture rectopexy with sigmoid resection is appealing as surgery is mainly confined to the pelvis. METHODS: The procedure is performed in modified lithotomy position using five trocars. In the case reported, the inferior mesenteric artery is divided distally to the left colic artery branch. The sigmoid colon is mobilized medially and may be mobilized laterally up to the descending colon, depending on the extent of resection. The splenic flexure remains in place. The rectum is mobilized from the presacral fascia down to the pelvic floor, sparing the hypogastric nerves. The rectum is transected in its upper third and the colonic stump pulled outside after enlarging the left lower abdominal incision to a length of 5 cm. The colorectal anastomosis is established intracorporeally in a double-stapling technique. Three 2-0 braided nonabsorbable sutures are placed to attach the right lateral stalks of the rectum to the presacral fascia. Proctoscopic examination has to ensure that there is no luminal compromise or air leakage. RESULTS: The videotape reports about a 37-year-old male patient with a rectal prolapse of 8 cm in length. First symptoms had occurred in childhood. He reported about temporary constipation and repeated rectal bleeding. During surgery, an elongated sigmoid was found. Laparoscopic sigmoid resection and suture rectopexy were carried out. There were no intraoperative or postoperative complications. The patient was discharged from the hospital on the sixth postoperative day. CONCLUSION: Laparoscopic resection rectopexy is safely feasible as a minimally-invasive treatment option for rectal prolapse.

Adult↗
PubMed1993

Constipation after rectopexy for rectal prolapse. Where is the obstruction?

The pathophysiology of constipation after rectopexy remains unclear: acquired anorectal dysfunction or preoperative colonic state are, by turns, the supposed culprit. The aim of this prospective study was to characterize the colorectal motility abnormalities encountered after such a surgical procedure. Twelve patients (10 females, 2 males, aged 50.5 +/- 5.2 years) complaining of severe constipation or its worsening after Orr rectopexy (OR) for rectal prolapse were studied. Each underwent detailed interrogation as to their symptoms, left colonic manometry (basal and postprandial motor indexes and their caudad gradients in the sigmoid), anorectal manometry, evacuation proctography, and colonic transit time with radiopaque markers. Results were compared to those obtained in two control groups: 10 healthy volunteers (HV) and 12 patients complaining of a rectal prolapse (RP) observed consecutively during the same period of evaluation (June 90 to December 91). Before surgery, the OR and RP groups were similar with respect to mean age, sex ratio, weekly stool frequency, subjective dyschezia and manual anal supplies, constipation symptoms, and anal incontinence. OR patients differed significantly from the RP group in having a lower weekly stool frequency (2.5 +/- 2.2 vs 5.2 +/- 3.7, P < 0.01) and a higher prevalence of abdominal pain (7 vs 1 patients, P < 0.05). Above the rectopexy, global (135.9 +/- 38 vs 51 +/- 30.5 hr, P < 0.01) and left (61.6 +/- 10 vs 18.2 hr, P < 0.01) colonic transit times were significantly higher in OR patients; moreover, the basal motor index gradient was negative in all but one case (-94.1 +/- 101 vs 177.3 +/- 131, P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗