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

Rectal Prolapse Clinical Trial

Official title:

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

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03643393
• Other study ID #: HMTT-VD-2018
• Status: Completed
• Phase: N/A
• Start date: May 1, 2015
• Est. completion date: June 30, 2018

Study information

• Verified date: August 2018
• Source: Viet Duc University Hospital
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial 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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 2
• Est. completion date: June 30, 2018
• Est. primary completion date: June 30, 2018
• Accepts healthy volunteers: No
• Gender: Male
• Age group: 52 Years to 69 Years

Eligibility

Inclusion Criteria:

• 2 cases incarceration rectalprolapse

Exclusion Criteria:

Related Conditions & MeSH terms

• Necrosis
• Prolapse
• Rectal Prolapse

Intervention

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.

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
Viet Duc University Hospital

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	recurrent rectal prolapse	patients were asked for symptoms such as: pain during bowel movements, mucus or blood discharge from the protruding tissue, a loss of urge to defecate, awareness of something protruding upon wiping	3 months after surgery