NCT03643393

Report 2 Cases of Massive Incarceration Necrosis Rectal Prolapse Are Successfully Treated With Altemeier's Procedure

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 2 (actual)
• Sponsor: Viet Duc University Hospital · Academic / Other
• Sex: Male
• Age: 52 Years – 69 Years
• Healthy volunteers: Not accepted

Summary

Incarceration and necrosis of rectal prolapse is rare and often requires urgent management. Perineal rectosigmoidectomy (Altemeir procedure) is a reasonable technique for this condition. The need for a diverting stoma depends on the patient's condition and the experience and judgement of the surgeon. A literature review was performed to determine optimal management of incarcerated and necrotic rectal prolapse, and to determine the indication for fecal diversion.

Conditions

• Rectal Prolapse

Interventions

Type	Name	Description
PROCEDURE	perineal rectosigmoidectomy	In an Altemeier perineal rectosigmoidectomy, a full-thickness circumferential incision is made in the prolapsed rectum about 1-2 cm from the dentate line (see the image below). The hernia sac is entered, and the prolapse is delivered. The mesentery of the prolapsed bowel is serially ligated until no further redundant bowel can be pulled down. The bowel is transected and either hand-sewn to the distal anal canal or stapled with a circular stapler. Before anastomosis, some surgeons plicate the levator ani muscles anteriorly, which may help improve continence.

Timeline

• Start date: 2015-05-01
• Primary completion: 2018-06-30
• Completion: 2018-06-30
• First posted: 2018-08-22
• Last updated: 2018-08-22