ALTMEIER PROCEDURE IN TOTAL RECTAL PROLAPSE SURGERY

Abstract

The article presents the results of a study conducted to improvement of the results of diagnostics and surgical treatment of patients with total rectal prolapse.

For the period from 2010 to 2021 41 patients of both sexes underwent Altmeier procedure. The age of the patients ranged from 26 to 85 years (median - 52.1±2.6). In diagnostics, preference is given to instrumental, mainly imaging research methods.

Postoperative surgical and general therapeutic complications occurred in 11 patients (26.8%), among which local (24.4%) prevailed - wound suppuration (5), suture insufficiency (2), pelvic floor abscesses (2) and anastomotic stenosis (1). Complications requiring repeated surgical placement were not observed. The degree of constipation and incontinence according to the Wexner scale decreased, respectively, more than 2 times and almost 1.5 times (all p<0.05). Residives developed in 2 patients (5.9%). There were no lethal outcomes.

Thus, in elderly and senile patients with concomitant somatic diseases with prolapse of all layers of the rectum more than 5.5 cm long (median 11.4±1.9 cm), it is recommended to perform the Altmeier procedure, which is characterized by a lower incidence of postoperative complications and residives (5.9%).