Abdominal vs. Perineal Surgery for Recurrent Rectal Prolapse: Research Highlights Higher Recurrence with Perineal Approach
Italy: A recent systematic review and meta-analysis have provided valuable insights into the effectiveness of perineal and abdominal surgical approaches for treating recurrent external rectal prolapse. The analysis revealed that the recurrence rate for the abdominal approach in treating recurrent external rectal prolapse was 15.6%, notably lower than the 27.9% observed with the perineal approach.
"Although both surgical techniques had comparable complication rates and hospital stays, the findings indicate that abdominal surgery may provide better patient outcomes," the researchers wrote in the International Journal of Colorectal Disease.
External rectal prolapse, characterized by the protrusion of the rectum through the anal opening, often necessitates surgical intervention, especially in recurrent cases. At the same time, surgery remains the most effective treatment, recurrence rates reported in the literature range from 6% to 27%. Surgeons typically select between perineal and abdominal approaches based on patient characteristics and clinical considerations. The perineal approach, including procedures like the Altemeier and Delorme techniques, is often favored for elderly or high-risk patients due to its lower perioperative morbidity and suitability for regional anesthesia. In contrast, the abdominal approach, encompassing laparoscopic and open rectopexy techniques, offers better anatomical support and durability, potentially reducing recurrence rates.
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