You could be reading the full-text of this article now if you...

If you have access to this article through your institution,
you can view this article in

Midterm Results After Perineal Stapled Prolapse Resection for External Rectal Prolapse

Sehmer, Diana M.D.1; Marti, Lukas M.D.2; Wolff, Katja M.D.2; Hetzer, Franc H. M.D.1

Diseases of the Colon & Rectum:
doi: 10.1097/DCR.0b013e31826cbbea
Original Contribution: Benign Colorectal Disease

BACKGROUND: Previous studies showed that perineal stapled prolapse resection for external rectal prolapse improves continence and has short operation times and low complication rates.

OBJECTIVE: The aim of this study was to assess the midterm recurrence rates, functional results, and patient satisfaction after perineal stapled prolapse resection.

DESIGN: This was a retrospective study.

SETTINGS: The study was performed at a tertiary hospital in Switzerland.

PATIENTS: From November 2007 to October 2011, a total of 56 consecutive patients were included in the study.

MAIN OUTCOME MEASURES: Recurrence rates, functional results according to the Wexner incontinence scale, and patient satisfaction using a visual analog scale were determined

RESULTS: The median age was 78.5 years (range, 24–94 years), and 2 patients were men. Midterm results were available for 46 (82%) of 56 patients after a median follow-up of 25.5 months (range, 2–47 months). In 10 cases (18%) data collection was not possible. The recurrence rate at 3 years was 19.7% (95% CI 4.2%–32.7%). The Wexner incontinence score improved from a median of 14.5 presurgery to 4.0 points (p < 0.0001) after surgery. Twenty-five patients (54%) stated that their bowel movements were regular postoperatively. On a visual analog scale that measured satisfaction, the median patient score was 9 (range, 0–10), indicating high patient satisfaction.

LIMITATIONS: Limitations included the retrospective study design and the lack of clinical examinations to determine recurrence rates.

CONCLUSIONS: Perineal stapled prolapse resection is an alternative technique for treating rectal prolapse with a recurrence rate similar to the Altemeier-Mikulicz or Delorme procedures. This technique is a quick and reliable procedure for use in patients with advanced age.

Author Information

1 Clinic of Surgery, Cantonal Hospital, Schaffhausen, Switzerland

2 Department of Surgery, Cantonal Hospital, St Gallen, Switzerland

Financial Disclosure: Drs Hetzer and Marti are paid consultants of Ethicon Endo-Surgery for stapled transanal rectal resection (STARR) with Contour Transtar, but they are not associated with Ethicon Endo-Surgery for the perineal stapled prolapse resection (PSP) technique used in this study. Ethicon Endo-Surgery was not involved in the study.

Correspondence: Franc H. Hetzer, M.D., Clinic of Surgery, Cantonal Hospital Schaffhausen, Geissbergstrasse 81, CH-8208 Schaffhausen, Switzerland. E-mail:

© The ASCRS 2013