BackgroundThe aim of this retrospective study was to evaluate morbidity, mortality, postoperative function and recurrences in patients treated by Altemeier's rectosigmoidectomy for complete rectal prolapse in a referral center for pelvic floor functional disorders.MethodsPeri-operative data on 43 consecutive female patients were reviewed. At follow-up any change in pelvic floor function and recurrences were determined. Thirty four patients were assessed at a median interval of 49 (2-135) months, six being deceased for reason not related to the prolapse and three lost to follow-up.ResultsPost-operative complications at 30days occurred in 18 patients (38%). Major complication occurred in only one patient that was pneumonia with lung failure. Major complications were not related to the ASA score, BMI or age [average age 76.4]. There was no post-operative mortality at 30days.At long-term follow-up functional results demonstrate a statistically significant decrease in the Obstructive Defecation Syndrome (ODS) score, but no statistically significant changes in the Vaizey score, the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) score and the urinary retention score. ODS score decreased with respect to levatorplasty and the change was statistically significant instead of Vaizey score in which were not.At the same follow-up there were 12 (35%) cases of recurrence with an estimated risk at 48months of 40%. There were no statistically significant differences between patients with and without recurrence regarding age (p=0.188), BMI (p=0.864), ASA score (p=0.433), previously repaired prolapse (p=0.398), previous hysterectomy (p=0.705), length of resected bowel (p=0.126), and levatorplasty (p=0.304). Patient satisfaction showed a mean of 8.8 and 6.4 respectively in patients without and with recurrences (p=0.012).ConclusionsAltemeier's procedure had in our series low complications rate and no mortality. It offered improved evacuation in constipated patients while didn't improve fecal and urinary continence. Recurrence of prolapse was 40% at four years.

Altemeier{'}s procedure for complete rectal prolapse; Outcome and function in 43 consecutive female patients / Trompetto, M.; Tutino, R.; Realis Luc, A.; Novelli, E.; Gallo, G.; Clerico, G.. - In: BMC SURGERY. - ISSN 1471-2482. - 19:1(2019). [10.1186/s12893-018-0463-7]

Altemeier{'}s procedure for complete rectal prolapse; Outcome and function in 43 consecutive female patients

Gallo, G.
Penultimo
Writing – Review & Editing
;
2019

Abstract

BackgroundThe aim of this retrospective study was to evaluate morbidity, mortality, postoperative function and recurrences in patients treated by Altemeier's rectosigmoidectomy for complete rectal prolapse in a referral center for pelvic floor functional disorders.MethodsPeri-operative data on 43 consecutive female patients were reviewed. At follow-up any change in pelvic floor function and recurrences were determined. Thirty four patients were assessed at a median interval of 49 (2-135) months, six being deceased for reason not related to the prolapse and three lost to follow-up.ResultsPost-operative complications at 30days occurred in 18 patients (38%). Major complication occurred in only one patient that was pneumonia with lung failure. Major complications were not related to the ASA score, BMI or age [average age 76.4]. There was no post-operative mortality at 30days.At long-term follow-up functional results demonstrate a statistically significant decrease in the Obstructive Defecation Syndrome (ODS) score, but no statistically significant changes in the Vaizey score, the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) score and the urinary retention score. ODS score decreased with respect to levatorplasty and the change was statistically significant instead of Vaizey score in which were not.At the same follow-up there were 12 (35%) cases of recurrence with an estimated risk at 48months of 40%. There were no statistically significant differences between patients with and without recurrence regarding age (p=0.188), BMI (p=0.864), ASA score (p=0.433), previously repaired prolapse (p=0.398), previous hysterectomy (p=0.705), length of resected bowel (p=0.126), and levatorplasty (p=0.304). Patient satisfaction showed a mean of 8.8 and 6.4 respectively in patients without and with recurrences (p=0.012).ConclusionsAltemeier's procedure had in our series low complications rate and no mortality. It offered improved evacuation in constipated patients while didn't improve fecal and urinary continence. Recurrence of prolapse was 40% at four years.
Rectal prolapse; Altemeier procedure; Perineal rectal resection; Pelvic floor disorders; Pelvic organ prolapse; Fecal incontinence; Urinary incontinence
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Altemeier{'}s procedure for complete rectal prolapse; Outcome and function in 43 consecutive female patients / Trompetto, M.; Tutino, R.; Realis Luc, A.; Novelli, E.; Gallo, G.; Clerico, G.. - In: BMC SURGERY. - ISSN 1471-2482. - 19:1(2019). [10.1186/s12893-018-0463-7]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1657537
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