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Laparoscopic implementation of the Altemeier procedure for recurrent rectal prolapse. Technical note

INTRODUCTION: Many surgical options exist to treat rectal prolapse with different indications, feasibility and results in urgent and complicated cases. These include perineal or abdominal approaches including rectopexy with or without resection. Perineal approaches have reduced surgical invasivity a...

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Autores principales: La Greca, Gaetano, Sofia, Maria, Primo, Stefano, Randazzo, Valentina, Lombardo, Rosario, Russello, Domenico
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4064421/
https://www.ncbi.nlm.nih.gov/pubmed/24846791
http://dx.doi.org/10.1016/j.ijscr.2014.04.011
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author La Greca, Gaetano
Sofia, Maria
Primo, Stefano
Randazzo, Valentina
Lombardo, Rosario
Russello, Domenico
author_facet La Greca, Gaetano
Sofia, Maria
Primo, Stefano
Randazzo, Valentina
Lombardo, Rosario
Russello, Domenico
author_sort La Greca, Gaetano
collection PubMed
description INTRODUCTION: Many surgical options exist to treat rectal prolapse with different indications, feasibility and results in urgent and complicated cases. These include perineal or abdominal approaches including rectopexy with or without resection. Perineal approaches have reduced surgical invasivity and hospital stay if compared to transabdominal approaches by open surgery or laparoscopy. Up to now there was still a clear dividing line for surgical treatment between the perineal approach, used more for complicated emergency case while the transabdominal open, or laparoscopic approach more common in elective surgery, but more complex to perform. PRESENTATION OF CASE: A 37 year old female patient affected by psychiatric disease presented with an unreducible second recurrence of a complicated rectal prolapse. The patient was treated with a third Altemeier procedure but now performed under laparoscopic control. The patient recovered promptly without any complication or recurrence up to the 24 months follow-up. DISCUSSION: To the best of our knowledge, this is the first case report describing the combined laparoscopic-perineal approach for the treatment of a complicated recurrence of rectal prolapse. The technical feasibility, the rapidity, the optimal outcome and the rationale behind this option all suggest that this laparoscopic assistance certainly allows an implementation of the effectiveness, safety and results of an established effective perineal approach. CONCLUSION: This combined approach has the advantage of maintaining the simplicity and rapidity of conventional perineal surgery, adding the advantages of abdominal control and avoiding the risks, the invasivity, and the longer duration of more complex laparoscopic procedures.
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spelling pubmed-40644212014-06-23 Laparoscopic implementation of the Altemeier procedure for recurrent rectal prolapse. Technical note La Greca, Gaetano Sofia, Maria Primo, Stefano Randazzo, Valentina Lombardo, Rosario Russello, Domenico Int J Surg Case Rep Article INTRODUCTION: Many surgical options exist to treat rectal prolapse with different indications, feasibility and results in urgent and complicated cases. These include perineal or abdominal approaches including rectopexy with or without resection. Perineal approaches have reduced surgical invasivity and hospital stay if compared to transabdominal approaches by open surgery or laparoscopy. Up to now there was still a clear dividing line for surgical treatment between the perineal approach, used more for complicated emergency case while the transabdominal open, or laparoscopic approach more common in elective surgery, but more complex to perform. PRESENTATION OF CASE: A 37 year old female patient affected by psychiatric disease presented with an unreducible second recurrence of a complicated rectal prolapse. The patient was treated with a third Altemeier procedure but now performed under laparoscopic control. The patient recovered promptly without any complication or recurrence up to the 24 months follow-up. DISCUSSION: To the best of our knowledge, this is the first case report describing the combined laparoscopic-perineal approach for the treatment of a complicated recurrence of rectal prolapse. The technical feasibility, the rapidity, the optimal outcome and the rationale behind this option all suggest that this laparoscopic assistance certainly allows an implementation of the effectiveness, safety and results of an established effective perineal approach. CONCLUSION: This combined approach has the advantage of maintaining the simplicity and rapidity of conventional perineal surgery, adding the advantages of abdominal control and avoiding the risks, the invasivity, and the longer duration of more complex laparoscopic procedures. Elsevier 2014-04-15 /pmc/articles/PMC4064421/ /pubmed/24846791 http://dx.doi.org/10.1016/j.ijscr.2014.04.011 Text en © 2014 The Authors http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).
spellingShingle Article
La Greca, Gaetano
Sofia, Maria
Primo, Stefano
Randazzo, Valentina
Lombardo, Rosario
Russello, Domenico
Laparoscopic implementation of the Altemeier procedure for recurrent rectal prolapse. Technical note
title Laparoscopic implementation of the Altemeier procedure for recurrent rectal prolapse. Technical note
title_full Laparoscopic implementation of the Altemeier procedure for recurrent rectal prolapse. Technical note
title_fullStr Laparoscopic implementation of the Altemeier procedure for recurrent rectal prolapse. Technical note
title_full_unstemmed Laparoscopic implementation of the Altemeier procedure for recurrent rectal prolapse. Technical note
title_short Laparoscopic implementation of the Altemeier procedure for recurrent rectal prolapse. Technical note
title_sort laparoscopic implementation of the altemeier procedure for recurrent rectal prolapse. technical note
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4064421/
https://www.ncbi.nlm.nih.gov/pubmed/24846791
http://dx.doi.org/10.1016/j.ijscr.2014.04.011
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