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

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 e...

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Bibliographic Details
Published in:British journal of surgery 2005-05, Vol.92 (5), p.598-604
Main Authors: Williams, N. S., Dvorkin, L. S., Giordano, P., Scott, S. M., Huang, A., Frye, J. N. R., Allison, M. E., Lunniss, P. J.
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Collagen
Female
General aspects
Humans
Intussusception - surgery
Male
Medical sciences
Middle Aged
Quality of Life
Rectal Diseases - surgery
Rectocele - surgery
Surgical Flaps
Treatment Outcome
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Summary: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. Copyright © 2005 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. New operative technique for intussusception and rectocele
ISSN:0007-1323
1365-2168
DOI:10.1002/bjs.4904