Rectoanal intussusception: presentation of the disorder and late results of resection rectopexy - PubMed (original) (raw)
Clinical Trial
Rectoanal intussusception: presentation of the disorder and late results of resection rectopexy
John Tsiaoussis et al. Dis Colon Rectum. 2005 Apr.
Abstract
Background: Rectoanal intussusception may cause symptoms of obstructed defecation, and functional results of prosthesis rectopexy are usually not satisfactory. The aim of this study was to assess several parameters of the disorder and to evaluate the outcome of resection rectopexy.
Methods: During a 10-year period, 27 female patients with symptomatic large rectoanal intussusception had resection rectopexy (23 laparoscopy; 4 laparotomy). Conservative treatment, including biofeedback treatment in 22 patients, had failed in all cases. Preoperative and postoperative evaluation included clinical assessment, anorectal manometry, evacuation defecography, and colon transit studies. Follow-up ranged between one and five years.
Results: Length of intussusception was 2 to 4.9 cm and was significantly related to pelvic floor descent (P = 0.003) and inversely related to resting anal pressures (P < 0.001). Eleven patients had undergone a previous hysterectomy, 9 had enterocele-sigmoidocele, 7 had incontinence of varying severity, and 8 had a solitary rectal ulcer. Colon transit was abnormal in all but five cases. Immediate functional results were bad in two-thirds of the cases; tenesmus, urge to defecate, and frequent stools were the main complaints. By the time these symptoms had subsided, and one year after surgery, all but two patients were satisfied with the outcome. Intussusception was reduced in all cases, anal sphincter tone recovered (P = 0.002), perineal descent decreased (P < 0.001), and colonic transit was accelerated (P < 0.001). Patients available at five-year follow-up had no or only minor defecatory problems.
Conclusion: Resection rectopexy improves symptoms of obstructed defecation attributed to large rectoanal intussusception.
Similar articles
- Outcome and management of patients with large rectoanal intussusception.
Choi JS, Hwang YH, Salum MR, Weiss EG, Pikarsky AJ, Nogueras JJ, Wexner SD. Choi JS, et al. Am J Gastroenterol. 2001 Mar;96(3):740-4. doi: 10.1111/j.1572-0241.2001.03615.x. Am J Gastroenterol. 2001. PMID: 11280544 - Laparoscopic ventral rectopexy, posterior colporrhaphy and vaginal sacrocolpopexy for the treatment of recto-genital prolapse and mechanical outlet obstruction.
Slawik S, Soulsby R, Carter H, Payne H, Dixon AR. Slawik S, et al. Colorectal Dis. 2008 Feb;10(2):138-43. doi: 10.1111/j.1463-1318.2007.01259.x. Epub 2007 May 10. Colorectal Dis. 2008. PMID: 17498206 - Resection rectopexy for internal rectal intussusception reduces constipation and incomplete evacuation of stool.
Johnson E, Carlsen E, Mjåland O, Drolsum A. Johnson E, et al. Eur J Surg Suppl. 2003 Jul;(588):51-6. Eur J Surg Suppl. 2003. PMID: 15200044 - [Practical approach to constipation in adults].
Hermann J, Kościński T, Drews M. Hermann J, et al. Ginekol Pol. 2012 Nov;83(11):849-53. Ginekol Pol. 2012. PMID: 23379194 Review. Polish. - Constipation of anorectal outlet obstruction: pathophysiology, evaluation and management.
Andromanakos N, Skandalakis P, Troupis T, Filippou D. Andromanakos N, et al. J Gastroenterol Hepatol. 2006 Apr;21(4):638-46. doi: 10.1111/j.1440-1746.2006.04333.x. J Gastroenterol Hepatol. 2006. PMID: 16677147 Review.
Cited by
- Functional disorders: rectoanal intussusception.
Weiss EG, McLemore EC. Weiss EG, et al. Clin Colon Rectal Surg. 2008 May;21(2):122-8. doi: 10.1055/s-2008-1075861. Clin Colon Rectal Surg. 2008. PMID: 20011408 Free PMC article. - [Transabdominal procedures for functional bowel diseases].
Kienle P, Horisberger K. Kienle P, et al. Chirurg. 2013 Jan;84(1):21-9. doi: 10.1007/s00104-012-2349-z. Chirurg. 2013. PMID: 23263682 Review. German. - Consensus statement AIGO/SICCR diagnosis and treatment of chronic constipation and obstructed defecation (part II: treatment).
Bove A, Bellini M, Battaglia E, Bocchini R, Gambaccini D, Bove V, Pucciani F, Altomare DF, Dodi G, Sciaudone G, Falletto E, Piloni V. Bove A, et al. World J Gastroenterol. 2012 Sep 28;18(36):4994-5013. doi: 10.3748/wjg.v18.i36.4994. World J Gastroenterol. 2012. PMID: 23049207 Free PMC article. - Proctalgia in a patient with staples retained in the puborectalis muscle after STARR operation.
De Nardi P, Bottini C, Faticanti Scucchi L, Palazzi A, Pescatori M. De Nardi P, et al. Tech Coloproctol. 2007 Dec;11(4):353-6. doi: 10.1007/s10151-007-0381-7. Epub 2007 Nov 30. Tech Coloproctol. 2007. PMID: 18060361 - Complications and reinterventions after surgery for obstructed defecation.
Pescatori M, Milito G, Fiorino M, Cadeddu F. Pescatori M, et al. Int J Colorectal Dis. 2009 Aug;24(8):951-9. doi: 10.1007/s00384-009-0639-9. Epub 2009 Jan 23. Int J Colorectal Dis. 2009. PMID: 19165491
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical
Research Materials