Diagnostic and the surgical treatment tactics in the rectal mucosa prolapse with the anal sphincter insufficiency

Keywords: prolapse of rectal mucosa; insufficiency of anal sphincter; circular mucosal resection; stapler mucosal resection; trasanal rectopexy.

Abstract

Objective. To improve the results of diagnosis and surgical treatment of rectal mucosa prolapse, complicated by the anal sphincter insufficiency.

Materials and methods. Analysis of the diagnosis and surgical treatment results in the rectal mucosa prolapse with the anal sphincter insufficiency was done in 23 patients, ageing 31 - 65 yrs old and the age median (41.5 ± 1.8) yrs old, of them 17 women-patients.

Results. There was revealed, that most frequently and in mostly progressive forms the rectal mucosa prolapse with the anal sphincter insufficiency occurs in women, aged more than 36 yrs old.

Conclusion. Miniinvasive transanal operations, submucosal injection procedures and sphincteroplasty “end-to-end” were used predominantly, owing less morbidity potency (26.1%), favorable remote functional results - the recurrence rate lowering (4.3%), the fecal incontinence degree lowering (78.6%), and the patients’ quality of life improvement.

Author Biography

S. S. Imanova, Azerbaijani Medical University, Baku, Azerbaijani Republic

Imanova Solmaz Soltan gızı - MD, PhD(Med), assistant professor.
Department of Surgical Diseases I
Azerbaijan Medical University, Baku, Republic of Azerbaijan
155, Samed Vurgun str., Baku, Azerbaijan
solmaz-doctor@mail.ru
+99450 220 02 24
https://orcid.org/0000-0003-1947-8939

References

Nelson RL. Epidemiology of fecal incontinence. Gastroenterology. 2004 Jan;126(1 Suppl 1):S3-7. doi: 10.1053/j.gastro.2003.10.010. PMID: 14978632.

Bharucha AE, Dunivan G, Goode PS, Lukacz ES, Markland AD, Matthews CA, et al. Epidemiology, pathophysiology, and classification of fecal incontinence: state of the science summary for the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) workshop. Am J Gastroenterol. 2015 Jan;110(1):127-36. doi: 10.1038/ajg.2014.396. Epub 2014 Dec 23. PMID: 25533002; PMCID: PMC4418464.

Fornell EU, Matthiesen L, Sjödahl R, Berg G. Obstetric anal sphincter injury ten years after: subjective and objective long term effects. BJOG. 2005 Mar;112(3):312-6. doi: 10.1111/j.1471-0528.2004.00400.x. PMID: 15713145.

Brown SR, Wadhawan H, Nelson RL. Surgery for faecal incontinence in adults. Cochrane Database Syst Rev. 2013 Jul 2;2013(7):CD001757. doi: 10.1002/14651858.CD001757.pub4. PMID: 23821339; PMCID: PMC7061468.

Laalim SA, Hrora A, Raiss M, Ibnmejdoub K, Toughai I, Ahallat M, et al. Direct sphincter repair: techniques, indications and results. Pan Afr Med J. 2013;14:11. French. doi: 10.11604/pamj.2013.14.11.2024. Epub 2013 Jan 7. PMID: 23504542; PMCID: PMC3597895.

Tsunoda A. Surgical Treatment of Rectal Prolapse in the Laparoscopic Era; A Review of the Literature. J Anus Rectum Colon. 2020 Jul 30;4(3):89-99. doi: 10.23922/jarc.2019-035. PMID: 32743110; PMCID: PMC7390613.

Omar A, Magdy Kh. Comparison between laparoscopic and open abdominal rectopexy for full-thickness rectal prolapse: controlled clinical trial. Inter Surg J [Internet]. Aug;4(8):2539-45. Available from: https://www.ijsurgery.com/index.php/isj/article/view/1516. doi: 10.18203/ 2349-2902.isj20173389.

Lehur PA, Pravini B, Christoforidis D. To staple or not to staple the symptomatic rectocele. Tech Coloproctol. 2020 Jan;24(1):1-3. doi: 10.1007/s10151-019-02132-5. Epub 2019 Dec 9. PMID: 31820193.

Frieling T. Stuhlinkontinenz: Ursache, Diagnostik und Therapie [Incontinence - Etiology, diagnostics and Therapy]. Dtsch Med Wochenschr. 2016 Aug;141(17):1251-60. German. doi: 10.1055/s-0042-110800. Epub 2016 Aug 24. PMID: 27557074.

Brown S. The evidence base for rectal prolapse surgery: is resection rectopexy worth the risk? Tech Coloproctol. 2014 Mar;18(3):221-2. doi: 10.1007/s10151-013-1077-9. Epub 2013 Oct 1. PMID: 24081547.

Tou S, Brown SR, Nelson RL. Surgery for complete (full-thickness) rectal prolapse in adults. Cochrane Database Syst Rev. 2015 Nov 24;2015(11):CD001758. doi: 10.1002/14651858.CD001758.pub3. PMID: 26599079; PMCID: PMC7073406.

Bishawi M, Foppa C, Tou S, Bergamaschi R; Rectal Prolapse Recurrence Study Group. Recurrence of rectal prolapse following rectopexy: a pooled analysis of 532 patients. Colorectal Dis. 2016 Aug;18(8):779-84. doi: 10.1111/codi.13160. PMID: 26476263.

Kim DS, Tsang CB, Wong WD, Lowry AC, Goldberg SM, Madoff RD. Complete rectal prolapse: evolution of management and results. Dis Colon Rectum. 1999 Apr;42(4):460-6; discussion 466-9. doi: 10.1007/BF02234167. PMID: 10215045.

Jorge JM, Wexner SD. Etiology and management of fecal incontinence. Dis Colon Rectum. 1993 Jan;36(1):77-97. doi: 10.1007/BF02050307. PMID: 8416784.

Madiba TE, Baig MK, Wexner SD. Surgical management of rectal prolapse. Arch Surg. 2005 Jan;140(1):63-73. doi: 10.1001/archsurg.140.1.63. PMID: 15655208.

Bartlett LM, Sloots K, Nowak M, Ho YH. Biofeedback therapy for faecal incontinence: a rural and regional perspective. Rural Remote Health. 2011;11(2):1630. Epub 2011 Mar 2. PMID: 21375356.

Bleier JI, Kann BR. Surgical management of fecal incontinence. Gastroenterol Clin North Am. 2013 Dec;42(4):815-36. doi: 10.1016/j.gtc.2013.09.006. Epub 2013 Nov 6. PMID: 24280402.

Hoel AT, Skarstein A, Ovrebo KK. Prolapse of the rectum, long-term results of surgical treatment. Int J Colorectal Dis. 2009 Feb;24(2):201-7. doi: 10.1007/s00384-008-0581-2. Epub 2008 Sep 13. PMID: 18791726.

Murphy PB, Wanis K, Schlachta CM, Alkhamesi NA. Systematic review on recent advances in the surgical management of rectal prolapse. Minerva Chir. 2017 Feb;72(1):71-80. doi: 10.23736/S0026-4733.16.07205-9. Epub 2016 Oct 6. PMID: 27711030.

Published
2021-10-28
How to Cite
Imanova, S. S. (2021). Diagnostic and the surgical treatment tactics in the rectal mucosa prolapse with the anal sphincter insufficiency. Klinicheskaia Khirurgiia, 88(5-6), 8-11. https://doi.org/10.26779/2522-1396.2021.5-6.08
Section
General Problems of Surgery