Wu L, Wu H, Mu S, Li XY, Zhen YH, Li HY. Surgical approaches for complete rectal prolapse. World J Gastrointest Surg 2025; 17(3): 102043 [DOI: 10.4240/wjgs.v17.i3.102043]
Corresponding Author of This Article
Hai-Yang Li, PhD, Professor, Key Laboratory of Hepatobiliary and Pancreatic Diseases Treatment and Bioinformatics Research Guizhou Medical University, Department of Hepatobiliary Surgery, The Affiliated Hospital of Guizhou Medical University, No. 28 Guiyi Street, Guiyang 550000, Guizhou Province, China. lihaiyang@gmc.edu.cn
Research Domain of This Article
Surgery
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Mar 27, 2025; 17(3): 102043 Published online Mar 27, 2025. doi: 10.4240/wjgs.v17.i3.102043
Surgical approaches for complete rectal prolapse
Long Wu, Huan Wu, Song Mu, Xiao-Yun Li, Yun-Huan Zhen, Hai-Yang Li
Long Wu, Song Mu, Xiao-Yun Li, Yun-Huan Zhen, Department of Anus and Intestinal Surgery, The Affiliated Hospital of Guizhou Medical University, Guiyang 550004, Guizhou Province, China
Huan Wu, Department of Infectious Disease, The Affiliated Hospital of Guizhou Medical University, Guiyang 550004, Guizhou Province, China
Hai-Yang Li, Key Laboratory of Hepatobiliary and Pancreatic Diseases Treatment and Bioinformatics Research Guizhou Medical University, Department of Hepatobiliary Surgery, The Affiliated Hospital of Guizhou Medical University, Guiyang 550000, Guizhou Province, China
Co-first authors: Long Wu and Huan Wu.
Co-corresponding authors: Yun-Huan Zhen and Hai-Yang Li.
Author contributions: Wu L and Wu H contributed equally to this work and should be considered co-first authors; Wu L, Wu H, and Mu S wrote the first version of the article; Zhen YH and Li HY revised the second and third versions of this study and helped with the English editing, and they contributed equally to this manuscript as co-corresponding author; Wu L, Wu H, and Li XY participated in the conception and design of the study and the drafting of the article; Wu L and Wu H designed the study and revised the manuscript. All authors have read and approved the final manuscript.
Supported by Science and Technology Fund Project of Guizhou Health Commission, No. gzwkj2023-042 and No. gzwkj2024-010; National Natural Science Foundation of China, No. 82060440; Guizhou Provincial Science and Technology Projects, No. QKHJC-ZK[2024]-210; Cultivation Program for General Projects of the National Natural Science Foundation of China, No. gyfynsfc[2023]-01; and Cultivation Program for Regional Projects of the National Natural Science Foundation of China, No. gyfynsfc[2024]-19.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hai-Yang Li, PhD, Professor, Key Laboratory of Hepatobiliary and Pancreatic Diseases Treatment and Bioinformatics Research Guizhou Medical University, Department of Hepatobiliary Surgery, The Affiliated Hospital of Guizhou Medical University, No. 28 Guiyi Street, Guiyang 550000, Guizhou Province, China. lihaiyang@gmc.edu.cn
Received: October 7, 2024 Revised: December 2, 2024 Accepted: January 11, 2025 Published online: March 27, 2025 Processing time: 140 Days and 1.9 Hours
Abstract
Complete rectal prolapse, characterized by the protrusion of the rectal wall layers through the anal canal, poses significant treatment challenges, particularly due to controversies surrounding surgical approaches and the absence of a standardized assessment system. This study comprehensively reviews the main surgical techniques for complete rectal prolapse, categorized as transabdominal and transperineal/transanal procedures. Despite various techniques, challenges persist, including high recurrence rates and potential complications. Factors influencing the choice of the surgical approach include patient characteristics, symptomatology, and surgical expertise. With advances in medical technology, laparoscopic and robotic surgeries offer promising avenues, albeit with considerations of cost and accessibility. Ultimately, treatment plans tailored to the individual needs of the patient and surgical expertise are essential. Although controversies remain, the continued refinement of surgical techniques holds promise for improving outcomes in complete rectal prolapse surgery.
Core Tip: Selection of the appropriate surgical method depends on patient age, comorbidities, and prolapse severity when managing complete rectal prolapse. For high-risk patients, minimally invasive techniques like Delorme’s or Thiersch’s procedures offer quick recovery, but with a higher recurrence rate. In contrast, more invasive procedures like ventral mesh rectopexy provide durable results for severe cases. Postoperative follow-up is crucial to monitor for complications such as recurrence and bowel dysfunction. Tailoring the approach to individual patient characteristics is key to achieving the best outcomes and minimizing long-term complications.
