Rectal Prolapse - Recto-Sigmoidopexy as Surgical Option: A Retrospective Study

BVC Jagadeesha, D.N. Puneeth, Ravindra Kumar TM, Manoj Koundinya, Akshay D, Sourabh Birje, Shiva Prasad
Author(s)
1Professor, Department of General Surgery, JJMMC, Davanagere, Karnataka, India. 2Assistant Professor, Department of General Surgery, JJMMC, Davanagere, Karnataka, India. 3Senior Specialist, Chigateri District General Hospital, Davangere, Karnataka, India. 4Senior Resident, Department of General Surgery, J. J. M. Medical College, Davangere, Karnataka, India. 5Resident, Department of General Surgery, JJMMC, Davanagere, Karnataka, India. 6Junior Resident, Department of General Surgery, J. J. M. Medical College, Davangere, Karnataka, India

Abstract

Background: Complete rectal prolapse is a disabling condition affecting elderly patients and is frequently associated with fecal incontinence and impaired quality of life. Surgical intervention remains the definitive treatment, with several abdominal and perineal procedures available. Recto-sigmoidopexy is a less extensive abdominal procedure that may be particularly suitable for elderly and high-risk patients. Aim:To evaluate the safety, functional outcomes, and long-term recurrence rates of recto-sigmoidopexy in patients with complete rectal prolapse.. Material and Methods: A retrospective study was conducted on 30 patients with complete rectal prolapse who underwent recto-sigmoidopexy at a tertiary care center. Patient demographics, operative details, postoperative complications, functional outcomes, and recurrence rates were analyzed. Patients were followed up for a median duration of 15 years. Results: The study cohort comprised 24 women and 6 men with a median age of 76 years. Preoperative fecal incontinence was present in 24 patients. The median operative time was 42 minutes, and the median fixation time was 8 minutes. Thiersch stitching was additionally performed in patients with bulky rectal prolapse to provide anal sphincter support. One patient developed postoperative bowel obstruction, which was managed conservatively. No device-related complications were observed. Overall, the procedure demonstrated favorable functional outcomes with low morbidity and acceptable recurrence rates during long-term follow-up. Conclusion: Recto-sigmoidopexy is a safe, simple, and time-efficient surgical option for complete rectal prolapse in elderly patients. It offers good functional outcomes, low postoperative morbidity, and acceptable long-term recurrence rates, making it a valuable treatment alternative, particularly in elderly and high-risk individuals.

Keywords: Rectal prolapse; Recto-sigmoidopexy; Fecal incontinence; Abdominal fixation.

Outline