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Rectoanal intussusception: presentation of the disorder and late results of resection rectopexy.
Dis Colon Rectum. 2005 Apr; 48(4):838-44.DC

Abstract

BACKGROUND

Rectoanal intussusception may cause symptoms of obstructed defecation, and functional results of prosthesis rectopexy are usually not satisfactory. The aim of this study was to assess several parameters of the disorder and to evaluate the outcome of resection rectopexy.

METHODS

During a 10-year period, 27 female patients with symptomatic large rectoanal intussusception had resection rectopexy (23 laparoscopy; 4 laparotomy). Conservative treatment, including biofeedback treatment in 22 patients, had failed in all cases. Preoperative and postoperative evaluation included clinical assessment, anorectal manometry, evacuation defecography, and colon transit studies. Follow-up ranged between one and five years.

RESULTS

Length of intussusception was 2 to 4.9 cm and was significantly related to pelvic floor descent (P = 0.003) and inversely related to resting anal pressures (P < 0.001). Eleven patients had undergone a previous hysterectomy, 9 had enterocele-sigmoidocele, 7 had incontinence of varying severity, and 8 had a solitary rectal ulcer. Colon transit was abnormal in all but five cases. Immediate functional results were bad in two-thirds of the cases; tenesmus, urge to defecate, and frequent stools were the main complaints. By the time these symptoms had subsided, and one year after surgery, all but two patients were satisfied with the outcome. Intussusception was reduced in all cases, anal sphincter tone recovered (P = 0.002), perineal descent decreased (P < 0.001), and colonic transit was accelerated (P < 0.001). Patients available at five-year follow-up had no or only minor defecatory problems.

CONCLUSION

Resection rectopexy improves symptoms of obstructed defecation attributed to large rectoanal intussusception.

Authors+Show Affiliations

Laboratory Unit of Gastrointestinal Motility, University Hospital of Crete, Heraklion, Greece.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

15747074

Citation

Tsiaoussis, John, et al. "Rectoanal Intussusception: Presentation of the Disorder and Late Results of Resection Rectopexy." Diseases of the Colon and Rectum, vol. 48, no. 4, 2005, pp. 838-44.
Tsiaoussis J, Chrysos E, Athanasakis E, et al. Rectoanal intussusception: presentation of the disorder and late results of resection rectopexy. Dis Colon Rectum. 2005;48(4):838-44.
Tsiaoussis, J., Chrysos, E., Athanasakis, E., Pechlivanides, G., Tzortzinis, A., Zoras, O., & Xynos, E. (2005). Rectoanal intussusception: presentation of the disorder and late results of resection rectopexy. Diseases of the Colon and Rectum, 48(4), 838-44.
Tsiaoussis J, et al. Rectoanal Intussusception: Presentation of the Disorder and Late Results of Resection Rectopexy. Dis Colon Rectum. 2005;48(4):838-44. PubMed PMID: 15747074.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rectoanal intussusception: presentation of the disorder and late results of resection rectopexy. AU - Tsiaoussis,John, AU - Chrysos,Emmanuel, AU - Athanasakis,Elias, AU - Pechlivanides,George, AU - Tzortzinis,Anastasios, AU - Zoras,Odysseas, AU - Xynos,Evaghelos, PY - 2005/3/5/pubmed PY - 2005/6/4/medline PY - 2005/3/5/entrez SP - 838 EP - 44 JF - Diseases of the colon and rectum JO - Dis Colon Rectum VL - 48 IS - 4 N2 - BACKGROUND: Rectoanal intussusception may cause symptoms of obstructed defecation, and functional results of prosthesis rectopexy are usually not satisfactory. The aim of this study was to assess several parameters of the disorder and to evaluate the outcome of resection rectopexy. METHODS: During a 10-year period, 27 female patients with symptomatic large rectoanal intussusception had resection rectopexy (23 laparoscopy; 4 laparotomy). Conservative treatment, including biofeedback treatment in 22 patients, had failed in all cases. Preoperative and postoperative evaluation included clinical assessment, anorectal manometry, evacuation defecography, and colon transit studies. Follow-up ranged between one and five years. RESULTS: Length of intussusception was 2 to 4.9 cm and was significantly related to pelvic floor descent (P = 0.003) and inversely related to resting anal pressures (P < 0.001). Eleven patients had undergone a previous hysterectomy, 9 had enterocele-sigmoidocele, 7 had incontinence of varying severity, and 8 had a solitary rectal ulcer. Colon transit was abnormal in all but five cases. Immediate functional results were bad in two-thirds of the cases; tenesmus, urge to defecate, and frequent stools were the main complaints. By the time these symptoms had subsided, and one year after surgery, all but two patients were satisfied with the outcome. Intussusception was reduced in all cases, anal sphincter tone recovered (P = 0.002), perineal descent decreased (P < 0.001), and colonic transit was accelerated (P < 0.001). Patients available at five-year follow-up had no or only minor defecatory problems. CONCLUSION: Resection rectopexy improves symptoms of obstructed defecation attributed to large rectoanal intussusception. SN - 0012-3706 UR - https://www.unboundmedicine.com/medline/citation/15747074/Rectoanal_intussusception:_presentation_of_the_disorder_and_late_results_of_resection_rectopexy_ L2 - http://link.springer.com/article/10.1007/s10350-004-0850-2 DB - PRIME DP - Unbound Medicine ER -