طريقة جراحية نوعية و فعالة لمعالجة هبوط المستقيم التام لدى البالغين

الملخص EN

Background& Objective: In spite of the significant progress in surgery , the "best" surgical technique for the management of complete rectal prolapse remains controversial, due to its low incidence, which is the cause that there are no large prospective randomized trials to attest to the superiority of one operation over an other.

mentioned in the medical Purpose: To highlight the Sudeck's operation (1922), that is rarely literature; and the modifications which I conducted on it.

This operation is performed transabdominal and its characterized by the fact that it reforms more than one pathological side of the rectal prolapse in adults; with very encouraging results.

Materials & Methods: A retrospective study was conducted in Damascus hospital, department of general surgery, on the medical records of 53 patients, ranging in age from 20 to 69 years (23 females and 30 males) between 1994 and 2007.

14 patients underwent the referred operation , 39 patients underwent the modified operation via preservation of lateral ligaments with taking into consideration that 18 of them underwent resection of sigmoid; the obtained results were compared with the results of recently mentioned Studies about this subject .

Results: Regarding the original operation there wasn't any recurrence ,The percentage of the constipation improvement was -11% , and the incontinence was 63% ,transitory urinary retention with impotence (14%), no morbidity.

Regarding the modified operation without resection there was 1 recurrence , 1 mucosal prolapse , The percentage of the constipation improvement was 60% , and the incontinence was 77% ,intraoperative sacral venous bleeding (10%) , transitory superficial wound infection (10%),transitory urinary retention (11%) , transitory impotence(8%),no morbidity .Regarding the modified operation with resection there was any recurrence , The percentage of the constipation improvement was 67% , and the incontinence was 86% .

transitory superficial wound infection (17%), anastomosis complications (0%), transitory urinary retention with impotence (9%)no morbidity .

The postoperative follow-up duration was 42 months for all patients of study Conclusion: The modified Sudeck's operation especially with resection can be used to manage the complete rectal prolapse in adults in a safety and good long-term results compared to other transabdominal and perineal procedures .Age and other conditions don't constitute any significant obstacle regarding this procedure because of its easiness and speed of its performing .