Surgical treatment of complete rectal prolapse. Experience at a colon and rectal surgery service

Rectal prolapse is as ancient humanity. Treatment must be surgical in adult patients. There is no gold standard procedure to date; thus, this has given rise to controversy. One objective was to analyze our results, complications, mortality, and recurrence in a Colorectal Surgery Service for surgical treatment of complete rectal prolapse. We reviewed records of all patients treated surgically with rectal prolapse at our Service from March 1995 to March 2001. 31 patients; 22 were female and nine male with age range of 24 to 89 years. Evolution time was 6 months to 40 years; 11 patients had preoperative incontinence. We carried our four procedures, abdominal procedure hospital stay was 4 to 7 days; we had 18% long-term complications with no mortality or recurrence. Hospital stay in perineal procedures was 1 to 2 days with one procedure associated with death due to AV blockade, with 14% recurrence for helicoidal suture procedure, and no complications. Altemeier procedure recurred at 1 month of surgery. Continence score of Miller improve postoperatively. Abdominal procedures have less recurrence than perineal procedures; abdominal procedures must be considered in young patients with low risk, and perineal procedures in older patients with high risk, that are coantraindications for a major surgical procedure.