Recurrence after perineal rectosigmoidectomy: when and why?. (November 2014)

• Record Type: Journal Article
• Authors: Kim, M.; Reibetanz, J.; Schlegel, N.; Krajinovic, K.; Köstler, H.; Germer, C.‐T.; Isbert, C.
• Is Part Of: Colorectal disease. Volume 16:Number 11(2014)
• Page Start: 920
• Page End: 924
• Publication Date: 2014-11
• Subjects: Colon (Anatomy) -- Diseases -- Periodicals; Rectum -- Diseases -- Periodicals; 616.34
• DOI: 10.1111/codi.12756
• Languages: English
• ISSNs: 1462-8910

Abstract

<abstract abstract-type="main" id="codi12756-abs-0001"> <title>Abstract</title> <sec id="codi12756-sec-0001" sec-type="section"> <title>Aim</title> <p>Reported recurrence rates after perineal rectosigmoidectomy (Altemeier's procedure) in patients with full‐thickness rectal prolapse vary from 0% to 60%. The object of this study was to analyse risk factors for recurrence after this procedure.</p> </sec> <sec id="codi12756-sec-0002" sec-type="section"> <title>Method</title> <p>From May 2004 to December 2012, 63 consecutive patients suffering from full‐thickness rectal prolapse undergoing perineal rectosigmoidectomy were included. Of these 46 were female and the median age of the whole group was 79 (30–90) years. The median follow‐up was 53 (3–99) months. Patient characteristics and operative parameters were compared between patients with and without recurrence.</p> </sec> <sec id="codi12756-sec-0003" sec-type="section"> <title>Results</title> <p>One patient died and another patient needed re‐operation. Eight full‐thickness recurrences occurred in eight patients after a median of 18 (6–48) months. Stapled compared with handsewn anastomosis (hazard ratio 7.96, 95% confidence interval 1.90–33.47; <italic>P </italic>=<italic> </italic>0.001) and shorter specimen length (hazard ratio 4.06, 95% confidence interval 0.97–16.99; <italic>P </italic>=<italic> </italic>0.03) increased the risk of recurrence in Cox regression analysis.</p> </sec> <sec id="codi12756-sec-0004" sec-type="section"> <title>Conclusion</title> <p>The operative technique including stapled anastomosis and length of the resected specimen seems to be associated with a high recurrence rate after perineal rectosigmoidectomy.</p> </sec> </abstract>