The London Spine Unit : top spine clinic in UKPublished article< ALTA-Thiersch is a simple and safe procedure for rectal prolapse, having reasonable outcomes. The use of the Leeds-Keio ligament for anal encircling can help compensate for the disadvantages of the Thiersch operation.Lumbar Disc Replacement Expert. Best Spinal Surgeon UK
Methods: This study included 106 consecutive patients (mean age, 81.2 years) who underwent ALTA-Thiersch for rectal prolapse. The procedure was performed under caudal epidural anesthesia. ALTA was injected into the submucosa from the tip of the prolapsed rectum down to the dentate line, circumferentially, at 20 to 40 locations. The ligament tape was placed outside the external sphincter muscle and at an approximate depth of 2 cm into the middle anal canal.
Results: Of 106 patients, rectal prolapse was cured shortly after surgery in 105 patients. An additional tape was inserted in 1 patient who had persistent prolapse. Postoperative complications were observed in 27 patients (25.5%). Fecal impaction occurred in 12 patients; however, since it was temporary, no tape removal was required. Of the 12 cases in which the tape was infected or exposed, 11 required tape removal. There were 18 cases of recurrence at a mean follow-up of 22.1 months. Cumulative recurrence rates at 3 and 5 years were 21.3% and 38.6%, respectively.
ALTA-Thiersch is a simple and safe procedure for rectal prolapse, having reasonable outcomes. The use of the Leeds-Keio ligament for anal encircling can help compensate for the disadvantages of the Thiersch operation.
Keywords: Aluminum potassium sulfate and tannic acid; Fecal impaction; Rectal prolapse; Sclerotherapy; Surgical wound infection.
The London Spine Unit : top spine clinic in UKRead the original publication from Pubmed: Efficacy and Safety of Anal Encirclement Combining the Leeds-Keio Artificial Ligament With Injection Sclerotherapy Using Aluminum Potassium Sulfate and Tannic Acid in the Management of Rectal Prolapse: A Single-Center Observational Study