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- Title
The Surgical Management of Rectal Prolapse.
- Authors
Soare, Cristian; Lasithiotakis, Konstantinos; Dearden, Helena; Singh, Shailendra; McNaught, Clare
- Abstract
Rectal prolapse is a debilitating condition predominant in the elderly female population. Etiological factors include age, multiparity, and anorexia. The diagnosis is clinical but a full assessment of pelvic floor function and the exclusion of organic disease are essential prior to operative intervention. As concomitant urogynecological disorders are present in a third of patients, discussion in a pelvic floor multidisciplinary team forum is mandated. Surgical correction can be performed using a perineal or an abdominal approach. The heterogeneity of trial design in the current literature makes direct comparison of the techniques difficult. Perineal approaches are generally preferred in high-risk, elderly patients as they can often be performed under regional anesthesia. The evidence surrounding the technical aspects of abdominal rectopexy, such as the need to perform a colectomy or the decision to preserve/divide the lateral ligaments, is examined in this review. In abdominal surgery, the use of minimally invasive laparoscopic techniques and enhanced recovery protocols are recommended.
- Subjects
PERINEUM surgery; ABDOMINAL surgery; MUSCLE physiology; PELVIC floor physiology; RECTAL prolapse; CLINICAL trials; OPERATIVE surgery; COLECTOMY; DECISION making; HEALTH care teams; CONDUCTION anesthesia; DISEASE risk factors
- Publication
Indian Journal of Surgery, 2021, Vol 83, p694
- ISSN
0972-2068
- Publication type
Article
- DOI
10.1007/s12262-019-02058-0