대한대장항문학회

Rectal prolapse means an abnormal descent of all layers of the rectum, with or without<br>protrusion through the anus, and is classified into incomplete and complete rectal prolapse.<br>Complete rectal prolapse is further divided into the first, second and third degree based on the<br>severity. The choice of the operation for rectal prolapse is controversial. Purpose: The aim of<br>this study was to evaluate the safety and effectiveness of the low anterior resection and<br>stapled colorectal end-to-end anastomosis with fixation of the lateral rectal ligaments in<br>rectal prolapse with redundant sigmoid colon. Methods : We describe our experience from<br>January 1989 through December 1998. During this period, eight cases of complete rectal<br>prolapse were managed at the Chunchon Sacred Heart Hospital, Hallym University. They<br>were all men. The average age of the patients was 37 years (range, 19 to 73) and the average<br>at onset before surgery was 19 years (range, 6 months to 33 years). At rectal examination<br>the patients were placed in either a left supine or squatting position and were asked to strain.<br>The duration of the follow-up assessment was ranged from one to seven years after<br>operation. All those patients were investigated by personal interview and physical<br>examination. Results : The most common complaint was protruding anal mass and anal<br>bleeding. Four patients were heavy alcohol abusers. Two patients had mental retardation.<br>Among them four patients had undergone prior anorectal procedure; two men had been<br>treated due to hemorrhoids. The average body weight was 55 kg. The average length of the<br>postoperative hospital stay was 16.8 days (range, 9 to 39 days). Preoperatively, there were 5<br>cases who had decreased anal sphincter tone. In all cases EEA staple was used for<br>anastomosis. The rectum was completely mobilized posteriorly and sutured to the sacrum.<br>There was no recurrence and incontinence in all patients. The lengths of removed bowel were<br>15 to 20 cm (average 16.2 cm). There was no postoperative mortality, but postoperative<br>adhesive ileus was developed in two patients, which were managed by conservative<br>treatment. Conclusions : In rectal prolpase, the low anterior resection of redundant sigmoid<br>colon and stapled colorectal end-to-end anastomosis with fixation of the lateral rectal<br>ligaments is one of the most efficient treatment.<br>