Longitudinal plication - a surgical strategy for complete rectal prolapse management
1 Department of General Surgery, School of Medicine, Faculty of Medical Sciences, University of Sulaimani, Sulaimani, Kurdistan Region, Iraq
2 Department of General Surgery, Sulaimani Teaching Hospital, Sulaimani, Kurdistan Region, Iraq
3 Department of Biochemistry, School of Medicine, Faculty of Medical Sciences, University of Sulaimani, Sulaimani, Kurdistan Region, Iraq
4 Department of Health, Kurdistan Institution for Strategic Studies and Scientific Research, Sulaimaniyah, Kurdistan Region, Iraq
5 Newham University Hospital, London E13 7SR, UK
6 Raparin University, Ranya, Kurdistan Region Government, Iraq
BMC Surgery 2014, 14:17 doi:10.1186/1471-2482-14-17Published: 24 March 2014
Rectal prolapse is a known problem since antiquity and the cause is not fully understood. Despite the presence of more than 100 lines of treatment, none of them is ideal.
Between the years of (2005–2011), thirty patients with full-thickness rectal prolapse were operated upon. Age ranged between (2–65 years) with a mean of 21.5 year. Male to female ratio was (2:1). Each prolapsed rectum was repaired with longitudinal plication (LP) at two or three points accordingly using braded polyglycolic acid – absorbable 1.0 suture material. Plications started by inserting a stitch at the most proximal part of the prolapse, followed by successive similar transverse stiches continuing in a spiral fashion till the mucocutaneous junction. We used three LP in adults and two in children. All of the patients where operated upon as a day-case procedure and discharged 6 hours after the operation.
In this series of patients, twenty-nine of them had complete recovery from the prolapse. Only one patient had recurrence 2 years after the operation, and the same procedure was applied successfully with uneventful post-operative period. Although twenty-three patients had fecal Incontinence, twenty-one of them regained continence after operation.
This method is an easy perineal procedure, with fewer complications. It can be performed for all age groups, in an ordinary surgical unit, by an expert anorectal surgeon. We found that our procedure is simple, safe and less invasive.