Treatment of Rectal Prolapse with Preoperative Constipation
This protocol addresses rectal prolapse in patients who present with preoperative constipation as a significant associated complaint. The presence of constipation before surgery influences the choice of operative approach and the goals of repair.
Clinical Goals
Surgery in this setting aims to eliminate the rectal prolapse and to correct the associated constipation — addressing both structural and functional outcomes in the same operative intervention.
Surgical Approach — Overview
The recommended operative strategy in this scenario involves a rectopexy augmented by sigmoid resection — combining prolapse fixation with bowel resection to address the constipation component. The specific technique, sequence, and full operative details are set out in the complete protocol.
Complete step-by-step surgical protocol available below ↓
References
DOI: 10.1097/DCR.0000000000000889
Sigmoid resection may be added to posterior suture rectopexy in patients with prolapse and preoperative constipation.
Resection rectopexy refers to the addition of a sigmoid resection to the standard suture rectopexy discussed above.
The goals of surgery to correct rectal prolapse are 3-fold: 1) to eliminate the prolapse through either resection or restoration of normal anatomy, 2) to correct associated functional abnormalities of constipation or incontinence, and 3) to avoid the creation of de novo bowel dysfunction.
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