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Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The operation of choice for complete rectal prolapse is controversial. We reviewed 169 patients undergoing 185 surgical procedures for rectal prolapse over a 27-year period. The most common surgical procedure employed was the Ripstein procedure (n = 142) and is the focus of this report. Other surgical procedures used included resection rectopexy (n = 18), anterior resection (n = 7), Altemeier's (n = 9), Delorme's (n = 2), and anal encirclement (n = 7). The median age was 59 years (range, 12-94 years), and the female-to-male ratio was 5:1. The incidence of fecal incontinence, solitary rectal ulcer syndrome, and prior surgery elsewhere for rectal prolapse was 40 percent, 12 percent, and 19 percent, respectively. Operative mortality was 0.6 percent; morbidity was 16 percent. Median follow-up was 4.2 years (range, 1-15 years). Complete recurrence of prolapse after the Ripstein procedure was 8 percent; one-third of these patients recurred 3 to 14 years after surgery. Fecal incontinence improved after the Ripstein procedure or resection rectopexy in about half the patients. Persistence of prior constipation was more common after the Ripstein procedure than after resection rectopexy (57 percent vs. 17 percent; P = 0.03, chi-squared). Fifteen patients developed constipation for the first time after the Ripstein procedure. About one in three patients, irrespective of surgical procedures, remained dissatisfied with the final outcome despite anatomic correction of the prolapse. The Ripstein procedure has proven to be a safe procedure with good anatomic repair of the prolapse and may improve continence. In the presence of constipation, procedures other than the Ripstein procedure may be preferable.
Dis Colon Rectum 1993 May
PMID:Ripstein procedure is an effective treatment for rectal prolapse without constipation. 848 71

We report a case of incarcerated rectal prolapse that could not be reduced after using the previously described application of ordinary table sugar. Gentle pressure caused the prolapsed rectum to perforate, and the small bowel herniated through the tear. This is only the second case reported in the literature of an ileal herniation through a perforated rectum after an attempted reduction of an incarcerated prolapse. It is the only reported case occurring after sugar application and the 42nd case of ileal herniation through the rectum from all causes.
Dis Colon Rectum 1997 Oct
PMID:Incarcerated rectal prolapse--rupture and ileal evisceration after failed reduction: report of a case. 971 69

Stapled hemorrhoidectomy (mucosectomy) is a new technique that has recently been introduced for the treatment of third-degree and fourth-degree hemorrhoids and rectal mucosal prolapse. We present a case of severe retroperitoneal sepsis complicating stapled hemorrhoidectomy that was successfully treated by conservative means, further surgery therefore being avoided. The literature on the more serious complications associated with stapled hemorrhoidectomy is reviewed.
Dis Colon Rectum 2002 Jun
PMID:Retroperitoneal sepsis complicating stapled hemorrhoidectomy: report of a case and review of the literature. 1207 37

Full thickness pouch prolapse following restroative proctocolectomy is an uncommon complication but likely to become more frequent as this population of patients grows older. Conventional procedures to correct the prolapse may be impossible or significantly risk permanent ileostomy formation. The Express technique which is relatively minimally invasive, is a perineal procedure which elevates and suspends the antero-lateral walls of the prolapsing pouch to the external surface of the pelvis, utilizing strips of long lasting collagen.
Dis Colon Rectum 2004 Aug
PMID:Full-thickness pouch prolapse after restorative proctocolectomy: a potential future problem treated by the new technique of external pelvic neorectal suspension (the Express procedure). 1548 59

Colorectal cancer is an excellent tumor model for evaluating novel therapeutic strategies. Development of a mechanistic understanding of how this cancer develops, spreads, and grows allows a tailored approach to all stages of treatment: prevention, adjuvant treatment, and therapy of advanced disease. We focus on therapy in the advanced disease setting, although progress in this area could lend itself to treatment of early or premalignant disease. In the last 20 years, information has been generated about the intracellular pathways of tumor formation, invasion, and metastasis. As a result, specific molecular processes have been targeted for therapeutic intervention, including cell surface growth factor receptors, proliferation signaling, cell cycling, apo-ptosis, angiogenesis, and matrix metalloproteinases. We review the scientific rationale for recently developed novel therapeutics in colorectal cancer, and the results of clinical trials to date. We also suggest appropriate clinical settings for specific targets and outline future directions of research.
Dis Colon Rectum 2005 Aug
PMID:Novel therapeutics in colorectal cancer. 1590 30

J-pouch prolapse is a rare complication after IPAA. To date, limited data exist regarding management of this condition, with most reported cases involving suture pouch pexy. We present our experience and technique with 3 patients who were treated with transabdominal mesh pexy repair.
Dis Colon Rectum 2015 Apr
PMID:Mesh pouch pexy in the management of J-pouch prolapse. 2575 6

Frederick Salmon was born in Bath. From his early career, he was fond of surgery, mostly interested in proctology. He had been specialized in London at St Bartholomew's Hospital. He was the founder of "The Infirmary for the Relief of the Poor Afflicted with Fistula and Other Disease of the Rectum," and the writer of one of the most important surgical treatises, the " Practical Observations on Prolapsus of the Rectum." In this book, Salmon described an innovative operation for procidentia, based on the principle "trans-fixing pins and excision." Although his work was too significant for the era, he was almost completely neglected by historians, most probably due to his clash with his fellow surgeons, who had been considered by him as scientifically inadequate in anorectal diseases.
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PMID:British Surgeon Frederick Salmon (1796-1868) and His "Trans-Fixing Pins and Excision" Surgical Procedure for the "Rectum Prolapsus". 2890 21

The pathogenesis of hemorrhoids is a weakening of the anal cushion and spasm of the internal sphincter. Bowel habits and lifestyles can be risk factors for hemorrhoids. The prevalence of hemorrhoids can encompass 4 to 55% of the population. Symptoms include bleeding, pain, prolapsing, swelling, itching, and mucus soiling. The diagnosis of hemorrhoids requires taking a thorough history and conducting an anorectal examination. Goligher's classification, which indicates the degree of prolapsing with internal hemorrhoids, is useful for choosing treatment. Drug therapy for hemorrhoids is typically utilized for bleeding, pain, and swelling. Ligation and excision (LE) is considered for Grade III and IV internal and external hemorrhoids. Rubber band ligation is used to treat up to Grade III internal hemorrhoids. Phenol almond oil is effective for internal hemorrhoids up to Grade III, while aluminum potassium sulfate and tannic acid have shown efficacy in treating prolapsing in internal hemorrhoids at Grades II, III, and IV. Procedure for prolapse and hemorrhoids (PPH) is surgically effective for Grade III internal hemorrhoids; however, the long-term prognosis is not favorable, with high recurrence rates. Separating ligation is effective surgical treatment for internal/external hemorrhoids Grade III and Grade IV. The basic approach to thrombosed external hemorrhoids and incarcerated hemorrhoids is conservative treatment; however, in some acute or severe cases, surgical resection is considered. Comparing the different instruments used for hemorrhoid surgery, all reduce operating time, blood loss, post-operative pain, and length of time until the return to normal activity. They do, of course, increase the cost of the procedure.
J Anus Rectum Colon 2017
PMID:Japanese Practice Guidelines for Anal Disorders I. Hemorrhoids. 3158 7

Inappropriate stoma site, improper management of stoma, and stoma complications lead to diminished quality of life of ostomates. Healthcare professionals involved in stoma creation and/or care should have the fundamental and updated knowledge of the management of stomas and their complications. This review article consists of the following major sections: principles of perioperative patient management, early complications, and late complications. In the "principles of perioperative patient management" section, the current concepts and trends in preoperative education, stoma site marking, postoperative education, and patient educational resources are discussed. In the "early complications" section, we have focused on the etiology and current management of ischemia/necrosis, fluid and electrolyte imbalances, mucocutaneous separation, and retraction. In the "late complications" section, we have focused on the etiology and current management of parastomal hernia, stoma prolapse, parastomal varices, and pyoderma gangrenosum. Pre- and postoperative patient education facilitates the patient's independence in stoma care and resumption of normal activities. Healthcare providers should have basic skills and updated knowledge on the management of stomas and complications of stomas, to act as the first crisis manager for ostomates.
J Anus Rectum Colon 2020
PMID:Current Management of Intestinal Stomas and Their Complications. 3200 73

Rectal prolapse is associated with debilitating symptoms including the discomfort of prolapsing tissue, mucus discharge, hemorrhage, and defecation disorders of fecal incontinence, constipation, or both. The aim of treatment is to eliminate the prolapse, correct associated bowel function and prevent new onset of bowel dysfunction. Historically, abdominal procedures have been indicated for young fit patients, whereas perineal approaches have been preferred in older frail patients with significant comorbidity. Recently, the laparoscopic procedures with their advantages of less pain, early recovery, and lower morbidity have emerged as an effective tool for the treatment of rectal prolapse. This article aimed to review the current evidence base for laparoscopic procedures and perineal procedures, and to compare the results of various techniques. As a result, laparoscopic procedures showed a relatively low recurrence rate than the perineal procedures with comparable complication rates. Laparoscopic resection rectopexy and laparoscopic ventral mesh rectopexy had a small advantage in the improvement of constipation or the prevention of new-onset constipation compared with other laparoscopic procedures. However, the optimal surgical repair has not been clearly demonstrated because of the significant heterogeneity of available studies. An individualized approach is recommended for every patient, considering age, comorbidity, and the underlying anatomical and functional disorders.
J Anus Rectum Colon 2020
PMID:Surgical Treatment of Rectal Prolapse in the Laparoscopic Era; A Review of the Literature. 3274 10


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