Clinical effect of Altemeier procedure on recurrent rectal prolapse

[Objective] To investigate the clinical effect of Altemeier procedure on recurrent rectal prolapse. [Methods] A retrospective analysis was conducted on the clinical data of 15 patients with recurrent rectal prolapse who were treated with Altemeier procedure from January 2019 to January 2022 in the D...

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Main Authors: Zhai Yuze, Wang Benjun, Han Weiwei, Yu Bianfang, Gao Qianfu
Format: Article
Language:zho
Published: Editorial Office of Journal of Colorectal & Anal Surgery 2024-02-01
Series:结直肠肛门外科
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Online Access:https://jcas.gxmuyfy.cn/cn/wqll/paper.html?id=162&cateName=2024%E5%B9%B4%20%E7%AC%AC30%E5%8D%B7%20%E7%AC%AC1%E6%9C%9F
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Summary:[Objective] To investigate the clinical effect of Altemeier procedure on recurrent rectal prolapse. [Methods] A retrospective analysis was conducted on the clinical data of 15 patients with recurrent rectal prolapse who were treated with Altemeier procedure from January 2019 to January 2022 in the Department of Anorectal surgery of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine and Linyi People's Hospital. Surgical related indicators, complications, anal function, anorectal pressure, recurrence and death were observed, recorded and analyzed. [Results] All 15 patients successfully completed the surgery with a surgery time of (138.7±46.8) min, intraoperative blood loss of(24.6±8.7) mL, and the hospital stay of (15.0±5.6) d. Among the 15 patients, 2 developed rectal bleeding postoperatively. One of them responded to conservative treatment with compound carrageenan ointment, and the bleeding symptoms resolved. The other patient did not respond to conservative treatment with hemostatic drugs, and electronic colonoscopy revealed internal hemorrhoid bleeding near the anastomosis. Surgical suture ligation was performed to stop the bleeding 4 months postoperatively. Three patients developed a sense of anal sagging, which improved after oral administration of Fufang Qinjia tablets (self-made medication in our hospital) for half a year. None of the patients developed complications such as anastomotic tear, stenosis, or pelvic abscess. Before surgery, the patients’ Wexner anal incontinence score was 12 (2, 18) points; at the 12th month after surgery, it was 6 (0, 13) points, with a statistically significant difference (Z=-2.543, P=0.011). At the 12th month after surgery, the patients’ anal resting pressure and maximum anal contractile pressure were higher than before surgery (P<0.001). As of October 30, 2023, the mean follow-up time was (12.0±4.3) months, and there were no cases of recurrence or death during the follow-up period. [Conclusion] Altemeier procedure is safe and reliable in the treatment of recurrent rectal prolapse and has good clinical effect.
ISSN:1674-0491