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Int J Colorectal Dis 2021 Mar 15. Epub 2021 Mar 15.

Division of Cancer Surgery, University of Melbourne, Sir Peter MacCallum Cancer Centre, Melbourne, Australia.

Introduction: Ventral mesh rectopexy is frequently performed as a means of improving the quality of life for sufferers of rectal prolapse. The minimally invasive approach is highly desirable but can be technically difficult to achieve in the narrow confines of the pelvis. The robotic platform is becoming a more common means of overcoming these difficulties, but evidence of an objective benefit over standard laparoscopy is scarce. Read More

Langenbecks Arch Surg 2021 Feb 4. Epub 2021 Feb 4.

Day Week Surgery Departmental Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via F Sforza 35, Milan, 20122, Italy.

Purpose: In the attempt to understand the reasons for and to find a solution to the high recurrence rate after perineal surgery for complete rectal prolapse, we retrospectively analysed the long-term results of Altemeier's procedure alone, or associated with Trans-Obturator Colonic Suspension (TOCS) in a large series of patients with a median interval of 84 months (range 6-258).

Methods: Medical records of 110 patients undergoing Altemeier with levatorplasty (group 1) and 20 patients submitted to the same procedure associated with TOCS (group 2) for newly diagnosed complete rectal prolapse were reviewed. All patients had been recruited after preoperative clinical examination, SF-36 quality of life, continence score and colonoscopy. Read More

Dis Colon Rectum 2021 May;64(5):592-600

1 Division of Colon and Rectal Surgery, University of Illinois at Chicago, Chicago, Illinois 2 Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois.

Background: Hemorrhoids are common and affect mainly the young and middle-aged populations. Current guidelines recommend treating grade I and II hemorrhoids with office-based procedures. These therapies usually require multiple applications. Read More

Gan To Kagaku Ryoho 2020 Dec;47(13):2210-2212

Dept. of Gastroenterological Surgery, Iseikai Hospital.

We herein report a case of application of sugar to the edematous stoma for obstructive rectal cancer. A 70-year-old male patient was diagnosed with rectal cancer, bowel obstruction and multiple lung metastases. Colostomy was performed. Read More

Dis Colon Rectum 2020 12;63(12):e565

Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.

J Obstet Gynaecol 2020 Aug 27:1-7. Epub 2020 Aug 27.

Department of Urogynaecology, St Mary's Hospital, Imperial College Healthcare NHS Trust, Paddington, London, UK.

The most appropriate method for repairing posterior vaginal wall prolapse is still debatable. Women with symptomatic prolapse scheduled to undergo surgical repair in the posterior compartment were randomised to standard posterior colporrhaphy (SPC) or fascial and vaginal epithelial plication (FEP). Participants were assessed with the Prolapse Quality of Life (P-QOL) questionnaire, pelvic organ prolapse quantification (POP-Q) examination and three-dimensional ultrasound (3D US) prior to surgery and 6 months postoperatively. Read More

Int Urogynecol J 2020 10 20;31(10):2019-2025. Epub 2020 Jul 20.

Colorectal Surgery Unit, General Surgery Department, Mansoura faculty of medicine, Mansoura University, Mansoura city, Egypt.

Introduction And Hypothesis: The present study aimed to assess the changes in manometric parameters after transperineal repair (TPR) of rectocele and interpret failure of symptom improvement in light of these changes.

Methods: This was an observational cohort study on patients with anterior rectocele who underwent TPR in the period of February 2016 to February 2019. Data collected included patients' demographics, rectocele size, Wexner constipation and incontinence scores, anal pressures, and rectal sensation before and 12 months after TPR. Read More

J Pediatr Surg 2020 Sep 28;55(9):1969-1973. Epub 2020 May 28.

Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. Electronic address:

Purpose: To determine if minimal dissection of the posterior wall of rectum can reduce rectal prolapse after laparoscopic assisted anorectal pull-through (LAARP) in male anorectal malformation (ARM) with rectourethral fistula.

Methods: Eighty-six male patients with ARM who underwent LAARP in our center between 2007 and 2018 were retrospectively analyzed. There were 45 cases of prostatic urethral fistula, 24 bulbar urethral fistulas, and 15 bladder neck fistulas. Read More

Ann Med Surg (Lond) 2020 Jul 11;55:33-35. Epub 2020 May 11.

Department of Visceral Surgery, Fattouma Bourguiba Hospital, Monastir, Tunisia.

Background: Rectal prolapse (RP) is an uncommon perineal disease. It is defined as a complete protrusion or intussusception of the rectum through the anus. Strangulation of the RP is rare. Read More

Mil Med 2020 09;185(9-10):e1794-e1802

Division of General Surgery, Department of Surgery, Uniformed Services University of the Health Sciences (USUHS)/Walter Reed National Military Medical Center, 8901 Wisconsin Ave, Bethesda, MD 20889.

Introduction: Anorectal diseases, among the most common surgical conditions, are underrepresented in medical training. The Fundamentals of Anorectal Technical Skills course was developed to provide cost-effective formal training in diagnosis of common anorectal conditions and in commonly performed anorectal procedures using the theories of deliberative practice and perceptual and adaptive learning.

Materials And Methods: First- through third-year general surgery and internal medicine residents and third- and fourth-year medical students participated in a course consisting of didactic instruction and hands on skills stations. Read More

J Surg Case Rep 2020 Apr 7;2020(4):rjaa057. Epub 2020 Apr 7.

Clarunis, University Center for Gastrointestinal and Liver Disease, St. Clara Hospital and University Hospital Basel, Spitalstrasse 21, CH-4031 Basel, Switzerland.

This report presents a 74-year-old renal transplant patient suffering of polymorphic-post-transplant-associated lymphoproliferative disease (P-PTLD) within an Eppstein-Barr Virus (EBV) associated mucocutaneous rectal ulcer (MCU). He was initially treated by stapled hemorrhoidopexy for a symptomatic grade III hemorrhoidal prolapse refractory to conservative treatment and rubber band ligations. This leads to severe urge, frequency and stool fragmentation. Read More

Acta Biomed 2020 03 19;91(1):139-141. Epub 2020 Mar 19.

Casa di Cura Siligato, Civitavecchia.

Hemorrhoidal disease is a very common disease characterized by the presence of a mucous prolapse of the rectum and by varicosis of the hemorrhoidal plexus. Medical therapy is mainly indicated for the treatment of symptoms such as bleeding, pain and itching. The use of the micronized purified flavonoid fraction (MPFF) has proven to be effective in treating symptoms of hemorrhoidal disease. Read More

ANZ J Surg 2020 05 18;90(5):879-880. Epub 2020 Mar 18.

Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.

How to perform a rectal prolapse reduction using intraluminal packing. Read More

Am J Case Rep 2020 Feb 20;21:e920431. Epub 2020 Feb 20.

Department of Surgery, University of Miyazaki Faculty of Medicine, Kiyotake, Miyazaki City, Miyazaki, Japan.

BACKGROUND Stoma prolapse is the full-thickness protrusion of bowel through a stoma, which occurs in 2% to 26% of colostomies. However, stoma prolapse complicated by small bowel incarceration is very rare, reported in only 3 cases thus far. To our knowledge, the present case is the first reported case of surgical treatment after preoperative manual reduction for small bowel incarceration. Read More

J Matern Fetal Neonatal Med 2020 Feb 4:1-5. Epub 2020 Feb 4.

G.A. Ushakova Obstetrics and Gynecology Department, Kemerovo State Medical University, Kemerovo, Russia.

Pelvic floor dysfunction (PFD) is a multifactorial condition that clinically manifests as the pelvic prolapse, urinary and/or rectal incontinence, and sexual dysfunction. We aimed to evaluate the efficacy of two pelvic floor trainers for the prevention of PFD in women during the postpartum period. This was a prospective, randomized, open-label study in 70 women in the postpartum period. Read More

Tech Coloproctol 2020 01 11;24(1):65-73. Epub 2019 Dec 11.

Department of Surgery, School of Medicine, School of Medicine of the Federal University of Ceará, Av Atilano de Moura 430, Fortaleza, Ceará, 60810-180, Brazil.

Background: The aim of this study was to evaluate the impact of the transanal repair of rectocele and rectal mucosectomy with a single circular stapler (TRREMS) on the treatment of obstructed defecation due to rectocele and to identify the predictive factors for unsuccessful results.

Methods: Consecutive patients with obstructed defecation symptoms (ODS) associated with rectocele who had the TRREMS procedure were included. Each patient was assessed by echodefecography, manometry, and colonic transit time as well as the Cleveland Clinic constipation score (CCS) before therapy and at follow-up after 6 months. Read More

Tech Coloproctol 2019 Jun 28;23(6):529-535. Epub 2019 Jun 28.

Department of Surgery, Westmead Hospital, Sydney, NSW, Australia.

Background: Laparoscopic ventral mesh rectopexy (LVR) is a treatment with promising results in external rectal prolapse, rectal intussusception, and rectocele. Because of the emergence of robotic-assisted surgery and the technical advantage it provides, we examined the potential role and place of robotic surgery in ventral rectopexy.

Methods: MEDLINE, PubMed, and other databases were searched, by two independent reviewers, to identify studies comparing robotic to laparoscopic ventral mesh rectopexy. Read More

GE Port J Gastroenterol 2019 May 31;26(3):169-175. Epub 2018 Aug 31.

Hospital Garcia de Orta, Almada, Portugal.

Background And Aims: Hemorrhoid disorders are common. This study aimed to assess the efficacy and safety of polidocanol foam injected at high doses with intravenous needle for the treatment of symptomatic internal hemorrhoids that prolapse or bleed.

Methods: We evaluated 2,000 consecutive patients with prolapsed hemorrhoids (grades II/III/IV) recruited over 6 years. Read More

Anim Reprod Sci 2019 Jul 11;206:11-16. Epub 2019 May 11.

Clinic for Ruminants, Vetsuisse-Faculty, Bremgartenstrasse 109a, University of Bern, 3012 Bern, Switzerland. Electronic address:

This prospective study was conducted to compare two treatment protocols for retained foetal membranes (RFM) in cattle. The routine therapy consisting of intrauterine tetracycline boluses was compared with the administration of ozone foam, both intrauterine therapies without attempts to manually remove the placenta. Cows undergoing caesarean section, suffering from uterine torsion or prolapse of the uterus, and other illnesses than RFM on the first day post-partum were excluded. Read More

Neurourol Urodyn 2019 08 7;38 Suppl 4:S7-S11. Epub 2019 May 7.

Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina.

Aims: To review the current literature on the development of latent stress urinary incontinence (SUI) or SUI that occurs following pelvic organ prolapse therapy in patients who were continent prior to therapy. To make recommendations on how to best evaluate and manage patients with pelvic organ prolapse who are continent.

Methods: This is a narrative review using Google scholar and cross referencing identified manuscripts. Read More

Ann Ital Chir 2018 ;89:552-555

Introduction: Accordingly with the new physiopathologic insights of the 70s and 80s, hemorrhoidal disease appears to originate not much from venous hyperplasia but rather from a progressive deterioration of connective and support tissues with subsequent venous and mucosal prolapse. In the late 90s a new surgical technique for a more physiological treatment of hemorrhoids was introduced: stapled prolassectomy.

Materials And Methods: Between October 2017 and June 2018 we performed 50 hemorrhoidal stapled prolassectomies under local-regional anesthesia. Read More

Rozhl Chir Summer 2018;97(9):419-422

Introduction: Bipolar radiofrequency-induced thermotherapy of advanced stage haemorrhoid disease has been used successfully at the Atlas Hospital in Zlin for ten years. The aim of this study was to evaluate long-term outcomes of the method.

Method: RFITTH is bipolar radiofrequency-induced thermotherapy of haemorrhoidal diseases. Read More

Trials 2018 Feb 5;19(1):90. Epub 2018 Feb 5.

National Bowel Research Cente (NBRC) - Digestive Disease, Barts and The London School of Medicine and Dentistry, Queen Mary, University of London, 4 Newark Street, London, E1 2AT, UK.

Background: Laparoscopic ventral mesh rectopexy (LVMR) is an established treatment for external full-thickness rectal prolapse. However, its clinical efficacy in patients with internal prolapse is uncertain due to the lack of high-quality evidence.

Methods: An individual level, stepped-wedge randomised trial has been designed to allow observer-blinded data comparisons between patients awaiting LVMR with those who have undergone surgery. Read More

Zhonghua Wei Chang Wai Ke Za Zhi 2017 Dec;20(12):1370-1374

Department of Colorectal Surgery, Zhongnan Hospital, Wuhan University, Wuhan 430071, China.

Objective: To evaluate the safety and efficacy of the perineal rectosigmoidectomy (Altemeier procedure) in the treatment of full thickness rectal prolapse.

Methods: Clinical and follow-up data of 52 patients with full thickness rectal prolapse undergoing Altemeier procedure in 9 hospitals from September 2010 to July 2016 were analyzed retrospectively. Of which 38 cases were from Zhongnan Hospital of Wuhan University, 1 case from Suizhou Central Hospital of Hubei province, 1 case from Jingzhou Second People's Hospital of Hubei province, 3 cases from Wuxue First People's Hospital of Hubei province, 1 case from Jingmen First People's Hospital of Hubei province, 1 case from Tuanfeng County Hospital of Hubei province, 4 cases from Jingzhou Central Hospital of Hubei province, 2 from PLA Rocket Army General Hospital, 1 case from the Affiliated Hospital of Xuzhou Medical University in Jiangsu province. Read More

Colorectal Dis 2017 Sep;19 Suppl 3:49-72

Affiliate section of the Association of Coloproctology of Great Britain and Ireland.

Aim: To assess the outcomes of rectal excisional procedures in adults with chronic constipation.

Method: Standardised methods and reporting of benefits and harms were used for all CapaCiTY reviews that closely adhered to PRISMA 2016 guidance. Main conclusions were presented as summary evidence statements with a summative Oxford Centre for Evidence-Based Medicine (2009) level. Read More

BMJ Case Rep 2017 May 24;2017. Epub 2017 May 24.

Department of Pediatrics, Asahi General Hospital, Chiba, Japan.

Lancet Gastroenterol Hepatol 2016 12 4;1(4):291-297. Epub 2016 Oct 4.

Department of Surgery, THG, Aarhus University Hospital, Denmark.

Background: Laparoscopic ventral mesh rectopexy for rectal prolapse has been widely used over the past decade to reduce postoperative functional bowel disorders. We aimed to compare changes in functional outcome 12 months after laparoscopic ventral mesh rectopexy versus laparoscopic posterior sutured rectopexy in patients with rectal prolapse.

Methods: In this double-blind, randomised trial, consecutive patients aged 18 years or older at a single centre in Denmark with full-thickness rectal prolapse were randomly assigned (1:1) to either laparoscopic ventral mesh rectopexy or laparoscopic posterior sutured rectopexy by drawing numbers from opaque envelopes, in blocks of four for patients with or without preoperative constipation. Read More

Colorectal Dis 2017 Sep;19(9):857-862

Department of Surgery, Bankstown Hospital, Sydney, New South Wales, Australia.

Aim: Laparoscopic ventral rectopexy (LVR) is a nerve-sparing technique for the treatment of rectal prolapse. Concerns about the use of synthetic meshes in the pelvis and the associated risk of erosion have led to the recent use of biological meshes in some colorectal units. This retrospective study aims to assess the outcomes of patients undergoing LVR using a noncross-linked nondermal biological mesh. Read More

Indian J Surg 2017 Feb 26;79(1):45-50. Epub 2016 Oct 26.

Department of Surgery, Seth Nandlal Dhoot Hospital, A1, MIDC, Chikalthana, Aurangabad, Maharashtra 431210 India.

Recurrent and chronic rectal prolapse might lead to irreducibility and ultimately gangrene of the rectum if neglected. Gangrenous rectal prolapse is a surgical emergency and needs urgent surgical management. In view of irreducibility and gangrenous bowel, it is not advisable to attempt manual reduction of rectal prolapse. Read More

Int Urogynecol J 2017 Oct 11;28(10):1499-1505. Epub 2017 Mar 11.

University of Sydney, Sydney, New South Wales, Australia.

Introduction And Hypothesis: Female pelvic organ prolapse is highly prevalent and childbirth has been shown to be an important risk factor. The study was carried out to observe if pelvic organ support deteriorates over time following a first birth.

Methods: This is a retrospective review using archived data sets of women seen in the context of two prospective perinatal imaging studies. Read More