Articles

Laparoscopic Rectopexy in Solitary Rectal Ulcer

Abstract

Patients with Solitary Rectal Ulcer Syndrome (SRUS) come to a physician with passage of mucus and bloody liquid within defecation. The treatment for SRUS is depended to the severity of symptoms and the existance of rectal prolapse. This study is a report of the assessing of rectopexy as surgical modalities for 62 medical treatment resistant SRUS patients who were referred to the gastrointestinal department of Shahid Sadoughi Medical University and Mojibian hospital. The present non-randomized clinical trial was carried out in 62 SRUS patients from 1991 till 2005. In these patients SRUS was confirmed by histology. They were symptomatic after conservative therapy and referred for surgical intervention. All of them had been undergone abdominal rectopexy by two laparoscopic surgeons. In our study, rectal bleeding and history of digitalization had the highest and lowest frequency of symptoms and signs in our cases respectively. Abdominal rectopexy was done in 39 cases and complete recovery in our cases was 69.23%. Complete recovery rate in cases with dysplasia (63.8%) was significantly higher than cases without that (P=0.04). Complete recovery rate in cases that had finger defecation (85%) was significantly higher than cases without that (50%) (P=0.03). Laparoscopic rectopexy is one of the main surgical techniques for treatment of SRUS. This technique can present complete recovery for SRUS patients. Some of them include topical medications, behavior modification supplemented by fiber and biofeedback and surgery were more available and studied. But it seems that education of SRUS patient conservative treatment remain cornerstone in the SRUS management.

Madigan MR, Morson BC. Solitary ulcer of the rectum. Gut 1969;10(11):871-81.

Cruveilhier J. Ulcere chronique du rectum. Paris: JB Bailliere; 1829.

Alberti-Flor JJ, Halter S, Dunn GD. Solitary rectal ulcer as a cause of massive lower gastrointestinal bleeding.Gastrointest Endosc 1985;31(1):53-4.

Bishop PR, Nowicki MJ, Subramony C, Parker PH. Solitary rectal ulcer: a rare cause of gastrointestinal bleeding in an adolescent with hemophilia A. J Clin Gastroenterol 2001;33(1):72-6.

Tjandra JJ, Fazio VW, Church JM, Lavery IC, Oakley JR, Milsom JW. Clinical conundrum of solitary rectal ulcer.Dis Colon Rectum 1992;35(3):227-34.

Haray PN, Morris-Stiff GJ, Foster ME. Solitary rectal ulcer syndrome: an underdiagnosed condition. Int JColorectal Dis 1997;12(5):313-5.

Kuijpers HC, Schreve RH, ten Cate Hoedemakers H. Diagnosis of functional disorders of defecation causing the solitary rectal ulcer syndrome. Dis Colon Rectum 1986;29(2):126-9.

Malouf AJ, Vaizey CJ, Kamm MA. Results of behavioral treatment (biofeedback) for solitary rectal ulcer syndrome. Dis Colon Rectum 2001;44(1):72-6.

Vaizey CJ, Roy AJ, Kamm MA. Prospective evaluation of the treatment of solitary rectal ulcer syndrome with biofeedback. Gut 1997;41(6):817-20.

Halligan S, Nicholls RJ, Bartram CI. Proctographic changes after rectopexy for solitary rectal ulcer syndrome and preoperative predictive factors for a successful outcome. Br J Surg 1995;82(3):314-7.

Sitzler PJ, Kamm MA, Nicholls RJ, McKee RF. Long-term clinical outcome of surgery for solitary rectal ulcer syndrome. Br J Surg 1998;85(9):1246-50.

Emmanuel AV, Kamm MA. Response to a behavioural treatment, biofeedback, in constipated patients is associated with improved gut transit and autonomic innervation. Gut 2001;49(2):214-9.

Marchal F, Bresler L, Brunaud L, Adler SC, Sebbag H, Tortuyaux JM, et al. Solitary rectal ulcer syndrome: a series of 13 patients operated with a mean follow-up of 4.5 years. Int J Colorectal Dis 2001;16(4):228-33.

Nicholls RJ, Simson JN. Anteroposterior rectopexy in the treatment of solitary rectal ulcer syndrome without overt rectal prolapse. Br J Surg 1986;73(3):222-4.

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IssueVol 49, No 12 (2011) QRcode
SectionArticles
Keywords
Defecation Laparoscopy Recovery Rectopexy Solitary rectal ulcer syndrome

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How to Cite
1.
Kargar S, Salmanroughani H, Binesh F, Taghipoor S, Kargar S. Laparoscopic Rectopexy in Solitary Rectal Ulcer. Acta Med Iran. 1;49(12):810-813.