A Study on Etiological Factors and Outcome of Rectal Prolapse

Aravind, R M (2013) A Study on Etiological Factors and Outcome of Rectal Prolapse. Masters thesis, Stanley Medical College, Chennai.

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Abstract

The study comprised of 30 cases of rectal prolapse admitted at The Govt. Stanley Medical College and Hospital, between May 2010 to October 2012 and who underwent surgery for the same by any method. • There was a male predominance in the ratio of 6.5 : 1. • Majority of the patients (40%) were in the age group of 41 – 60yrs, with mean age of presentation of 46.5yrs. • All patients presented with mass per rectum and mucus discharge per rectum. • 16% of the patients had constipation while none of them presented with incontinence to stools. • The incidence of partial and complete prolapse were almost equal (53% - partial prolapse, 47%-complete prolapse). • Majority of the patients (53%) had normal findings on sigmoidoscopy. • All the patients of partial prolapse underwent Delorme’s procedure. • Among the patients with complete prolapse, 9 patients underwent abdominal mesh rectopexy, 2 patients underwent perineal mesh rectopexy, and 2 underwent abdominal resection and fixation. One patient who presented with irreducible prolapse was subjected for emergency reduction under GA followed by Thiersch’s procedure followed by elective abdominal mesh rectopexy. • Patients undergoing perineal procedures had a shorter hospital stay when compared to those undergoing abdominal procedures. • None of the patients had significant postoperative complication like mesh infection, haemorrhage, incontinence etc. • Only one patient developed recurrence (3.3%). CONCLUSION: Rectal prolapse is a distressing condition, pathophysiology of which is unknown. Etiological factors could not be identified in most of the cases even after the use of all the available investigations. Most common presenting symptom is mass descending per rectum with mucus discharge. Incarcerated prolapse, though rare, is a dreaded complication in rectal prolapse due to the considerable morbidity and mortality. Careful consideration of the patient’s information and surgeon’s experience is required before choosing the appropriate procedure. In general, perineal procedures have shorter duration of hospital stay, less morbidity and early return to normal activity when compared to the abdominal procedures, but, the recurrence rates are generally high when compared to abdominal procedures. Before choosing any treatment strategy for rectal prolapse, attention must also be paid to the functional outcome like quality of life and continence.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Rectal Prolapse ; Etiological Factors and Outcome.
Subjects: MEDICAL > General Surgery
Depositing User: Devi S
Date Deposited: 03 Apr 2018 03:19
Last Modified: 03 Apr 2018 03:19
URI: http://repository-tnmgrmu.ac.in/id/eprint/6797

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