Procidentia: Surgical treatment

Publisher Website
Google Scholar
Abstract
Summary The surgical experience at the Mayo Clinic with 124 cases of rectal prolapse during the 16 years before December 31, 1967, has been presented. Anterior resection was performed in 28 patients, with one death and one recurrence (3.7 per cent); the Pemberton operation allowed recurrence in 22 of 68 cases (32.4 per cent); recurrence after the Altemeier procedure occurred in five of 13 cases (38.5 per cent). Other operations were of limited application. Combining a review of the surgical literature with our results allowed several conclusions about the efficacy of the various operations for this condition. Anterior resection, with or without suspension procedures, is recommended for good-risk patients of all ages, reserving the Thiersch operation for older, debilitated, poor-risk patients. The Pemberton procedure with suture of rectal stalks to the sacral fascia may be used in intermediate-risk groups. Those procedures reported by Ripstein and Wells deserve consideration. An attempt has been made to evaluate incontinence preoperatively and postoperatively, and to judge the efficacy of various operations in improving or preventing incontinence. This remains an enigma.