学術雑誌論文 Laparoscopic Suture Rectopexy for Treatment of Refractory Full-Thickness Rectal Prolapse in 5 Patients Aged 90-100 Years

Funahashi, Kimihiko  ,  Kurihara, Akiharu  ,  Ushigome, Mitsunori  ,  Kagami, Satoru  ,  Suzuki, Takayuki  ,  Koda, Takamaru  ,  Kimura, Kazutaka  ,  Koike Junichi  ,  Shiokawa, Hiroyuki  ,  Imamura, Shigeki  ,  Miura, Yasuyuki  ,  Kaneko, Tomoaki

3 ( 2 )  , pp.66 - 70 , 2017-6 , The Medical Society of Toho University
ISSN:21891990
内容記述
Case Report
Full-thickness rectal prolapse (FTRP) is common among elderly adults and greatly impairs quality of life. We report successful use of laparoscopic suture rectopexy to treat FTRP in 5 patients aged 90-100 years. The median age of patients was 92 years (range, 90-100 years). Three of the 5 patients had recurrent FTRP that was previously managed by a transperineal procedure. All patients had massive protrusion of the rectal wall (range 50-150 mm), and FTRP greatly adversely affected quality of life. No severe comorbidities were noted in any patient preoperatively. All patients had an American Society of Anesthesiologists physical status classification of II. Laparoscopic suture rectopexy for all patients was selected after consultation with anesthesiologists. Although there were no deaths, medical complications were observed in 3 patients: 2 developed mild heart failure (Clavien-Dindo classification, grade I) and one had AU20aspiration pneumonitis (Clavien-Dindo classification, grade III). There were no complications associated with laparoscopic suture rectopexy. All patients were able to return home after surgery. Our experience suggests that laparoscopic suture rectopexy without resection is beneficial for selected patients older than 90 years who are active and in good general health. However, when treating very elderly patients, cautious evaluation of operative risks and careful perioperative management are required in order to avoid surgical complications.
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