ABSTRACT
Rectal prolapse remains an uncommon disorder, the optimal surgical treatment of which
has eluded surgeons for centuries. Recently, there has been resurgent interest in
the use of perineal approaches for its management. Compared with transabdominal approaches,
perineal approaches have long been felt to be less technically demanding for the surgeon
and to be less stressful on the patient, permitting an expedient and uneventful recovery
for even the highest-risk patient. Reports of improved recurrence rates, amelioration
of symptoms of fecal incontinence, and lack of exacerbation of constipation and sexual
dysfunction have made perineal approaches to rectal prolapse attractive. Perineal
approaches currently in use include perineal rectosigmoidectomy (Altemeier procedure),
mucosal sleeve resection (Delorme procedure), and anal encirclement (Thiersch procedure).
This article describes these procedures as they are used to treat rectal prolapse
and provides an update of the most recent results reported with these procedures.
KEYWORD
Procidentia - rectal prolapse - Altemeier - Delorme - Thiersch - perineal rectosigmoidectomy
