PMID- 28083601
OWN - NLM
STAT- MEDLINE
DCOM- 20180827
LR  - 20181113
IS  - 1433-0385 (Electronic)
IS  - 0009-4722 (Linking)
VI  - 88
IP  - 7
DP  - 2017 Jul
TI  - [Intraoperative pitfalls and complications in defecation disorders and rectal 
      prolapse].
PG  - 602-610
LID - 10.1007/s00104-016-0366-z [doi]
AB  - BACKGROUND: No generally accepted gold standard exists for the operative therapy 
      of rectal prolapse in its variety of manifestations. Existing evidence suggests 
      that an individualized choice of procedure provides the best result for each 
      single patient. Knowledge of possible pitfalls and intraoperative management of 
      complications in frequently applied procedures are important prerequisites for 
      reliable treatment of affected patients. MATERIAL AND METHODS: A consecutive 
      series of 233 patients (June 2011-May 2016) with individualized choice of 
      operative procedure in patients with rectal prolapse and rectocele based on an 
      algorithm for a clinical treatment pathway and stapled hemorrhoidopexy were 
      included. Intraoperative pitfalls and complications and their management (iPCM) 
      were prospectively documented and analyzed. RESULTS: The iPCM could be classified 
      into three different categories: group I: iPCM was immediately noted and 
      intraoperatively treated with no impact on the further clinical course (n = 20), 
      group II: iPCM was successfully treated conservatively within a short time after 
      the procedure (n = 9) and group III: iPCM required surgical revision (n = 5). 
      CONCLUSION: Individualized treatment of rectal prolapse and rectocele requires 
      a broad spectrum of methods in specialized coloproctology units. A clinical 
      treatment pathway facilitates the optimal choice of procedure. Overall the 
      complication rates during surgical treatment of transanal rectal prolapse are 
      low; however, available operative procedures hold specific risks and knowledge of 
      these risks helps to avoid them. Once complications occur, measures demonstrated 
      in this study lead to normal clinical courses in the majority of cases.
FAU - Buhr, J
AU  - Buhr J
AD  - Klinik fur Allgemein- u. Viszeralchirurgie mit Sektion Proktologie, 
      Raphaelsklinik Munster, Loerstrasse 23, 48143, Munster, Deutschland.
FAU - Hoffmann, M W
AU  - Hoffmann MW
AD  - Klinik fur Allgemein- u. Viszeralchirurgie mit Sektion Proktologie, 
      Raphaelsklinik Munster, Loerstrasse 23, 48143, Munster, Deutschland.
FAU - Allemeyer, E H
AU  - Allemeyer EH
AD  - Klinik fur Allgemein- u. Viszeralchirurgie mit Sektion Proktologie, 
      Raphaelsklinik Munster, Loerstrasse 23, 48143, Munster, Deutschland. 
      e.allemeyer@raphaelsklinik.de.
LA  - ger
PT  - Journal Article
TT  - Intraoperative Fallstricke und Komplikationen bei Stuhlentleerungsstorung und 
      Rektumprolaps.
PL  - Germany
TA  - Chirurg
JT  - Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen
JID - 16140410R
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - *Defecation
MH  - Female
MH  - Hemorrhoidectomy/instrumentation
MH  - Hemorrhoids/*surgery
MH  - Humans
MH  - Intraoperative Complications/*etiology/*surgery
MH  - Laparoscopy/instrumentation/methods
MH  - Male
MH  - Middle Aged
MH  - Precision Medicine
MH  - Prospective Studies
MH  - Rectal Prolapse/*surgery
MH  - Rectocele/*surgery
MH  - Reoperation/instrumentation/methods
MH  - Risk Factors
MH  - Surgical Instruments
MH  - Surgical Stapling/instrumentation
OTO - NOTNLM
OT  - Clinical pathway
OT  - Complication management
OT  - Pitfalls
OT  - Rectal prolapse
OT  - Rectocele
EDAT- 2017/01/14 06:00
MHDA- 2018/08/28 06:00
CRDT- 2017/01/14 06:00
PHST- 2017/01/14 06:00 [pubmed]
PHST- 2018/08/28 06:00 [medline]
PHST- 2017/01/14 06:00 [entrez]
AID - 10.1007/s00104-016-0366-z [pii]
AID - 10.1007/s00104-016-0366-z [doi]
PST - ppublish
SO  - Chirurg. 2017 Jul;88(7):602-610. doi: 10.1007/s00104-016-0366-z.