Laparoscopic Suture Rectopexy for Complete Rectal Prolapse
Laparoscopic Suture Rectopexy for Complete Rectal Prolapse
Introduction Solitary rectal ulcer syndrome is a condition in which an ulcer occurs in the rectum. There is evidence that solitary rectal ulcer syndrome is associated with rectal prolapse either overt or occult and that stopping complete rectal prolapse may lead to rapid healing of the solitary rectal ulcer. A huge variety of operative techniques have been described in the literature to correct this condition. We present the case of a patient who underwent hand-assisted laparoscopic suture rectopexy for complete rectal prolapse complicated by a solitary ulcer and obstructed defecation.
Case Presentation A 32-year-old Caucasian woman presented to our institute complaining of having had difficulty with her bowel movements, a rectal prolapse and pain in the anal area for one and a half years. She was checked in hospital for suspected rectal carcinoma, however, the examination revealed rectal ulceration. A diagnosis of complete rectal prolapse complicated by a solitary ulcer and obstructed defecation was established. The symptoms persisted so a hand-assisted laparoscopic suture rectopexy was performed. After six months of follow-up, her bowel movements had improved, she was experiencing no pain and the rectal ulcer had healed.
Conclusion A hand-assisted laparoscopic suture rectopexy is a feasible and safe surgical treatment of rectal prolapse with solitary rectal ulcer syndrome, providing complete recovery for patients with solitary rectal ulcer syndrome.
Complete rectal prolapse (procidentia) is the protrusion of the entire thickness of the rectal wall through the anal sphincter complex. Patients with rectal prolapse suffer from anal incontinence (50 to 75 percent), constipation (30 to 50 percent), mucus or blood discharge from the protruding tissue (25 percent) and pain during bowel movements. There is evidence that solitary rectal ulcer syndrome (SRUS) is associated with rectal prolapse either overt or occult. SRUS is a chronic disease in which a benign ulceration area develops in the rectum. This case confirms that stopping complete rectal prolapse may lead to rapid healing of the solitary rectal ulcer. Historically the standard treatment for complete rectal prolapse consists of surgery with a transabdominal or perineal approach. Abdominal rectopexy gives low recurrence rates and functional improvement in the majority of cases. However, rectal prolapse is a disease primarily affecting older people, so various perineal approaches are also used. A possible alternative is laparoscopic rectopexy or hand-assisted laparoscopic rectopexy. It represents the latest development in the evolution of surgical treatment of rectal prolapse and it is one of the main surgical techniques for the treatment of SRUS, providing complete recovery for patients with SRUS. This method gives the good functional outcome of the abdominal procedure and the benefits of minimally invasive surgery too.
Abstract and Introduction
Abstract
Introduction Solitary rectal ulcer syndrome is a condition in which an ulcer occurs in the rectum. There is evidence that solitary rectal ulcer syndrome is associated with rectal prolapse either overt or occult and that stopping complete rectal prolapse may lead to rapid healing of the solitary rectal ulcer. A huge variety of operative techniques have been described in the literature to correct this condition. We present the case of a patient who underwent hand-assisted laparoscopic suture rectopexy for complete rectal prolapse complicated by a solitary ulcer and obstructed defecation.
Case Presentation A 32-year-old Caucasian woman presented to our institute complaining of having had difficulty with her bowel movements, a rectal prolapse and pain in the anal area for one and a half years. She was checked in hospital for suspected rectal carcinoma, however, the examination revealed rectal ulceration. A diagnosis of complete rectal prolapse complicated by a solitary ulcer and obstructed defecation was established. The symptoms persisted so a hand-assisted laparoscopic suture rectopexy was performed. After six months of follow-up, her bowel movements had improved, she was experiencing no pain and the rectal ulcer had healed.
Conclusion A hand-assisted laparoscopic suture rectopexy is a feasible and safe surgical treatment of rectal prolapse with solitary rectal ulcer syndrome, providing complete recovery for patients with solitary rectal ulcer syndrome.
Introduction
Complete rectal prolapse (procidentia) is the protrusion of the entire thickness of the rectal wall through the anal sphincter complex. Patients with rectal prolapse suffer from anal incontinence (50 to 75 percent), constipation (30 to 50 percent), mucus or blood discharge from the protruding tissue (25 percent) and pain during bowel movements. There is evidence that solitary rectal ulcer syndrome (SRUS) is associated with rectal prolapse either overt or occult. SRUS is a chronic disease in which a benign ulceration area develops in the rectum. This case confirms that stopping complete rectal prolapse may lead to rapid healing of the solitary rectal ulcer. Historically the standard treatment for complete rectal prolapse consists of surgery with a transabdominal or perineal approach. Abdominal rectopexy gives low recurrence rates and functional improvement in the majority of cases. However, rectal prolapse is a disease primarily affecting older people, so various perineal approaches are also used. A possible alternative is laparoscopic rectopexy or hand-assisted laparoscopic rectopexy. It represents the latest development in the evolution of surgical treatment of rectal prolapse and it is one of the main surgical techniques for the treatment of SRUS, providing complete recovery for patients with SRUS. This method gives the good functional outcome of the abdominal procedure and the benefits of minimally invasive surgery too.
Source...