FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2012889851> ?p ?o ?g. }

• W2012889851 endingPage "222" @default.
• W2012889851 startingPage "221" @default.
• W2012889851 abstract "The optimal operation for rectal prolapse is unclear. Various options exist. Broadly, one can carry out the operation via a perineal or abdominal approach. If perineal, should it be a Delormes or rectosigmoidectomy combined with a levatorplasty or not? If abdominal, should it be open or laparoscopic and should the rectum be simply mobilised or fixed? If fixed, what with and where from and to? Should the lateral ligaments be divided or preserved and should the redundant sigmoid be resected? With such a huge variation in techniques, what is the evidence that will tell us what the best approach for prolapse surgery is? Unfortunately, the literature is full of poor quality data mainly from case series and expert opinion. So the first step must be to concentrate on only the quality comparative data in the form of randomised controlled trials. Can this data tell us anything? The next step is to decide what outcome to assess. The obvious outcome is recurrence. When considering the two broad approaches, there is a perception that an abdominal procedure will result in a lower incidence of recurrence. Indeed, the recurrence rate for any perineal procedure may be greater than 40 % if the patient is followed up for long enough [1]. Is there good quality comparative data to back up this perception that the abdominal procedure is more robust? Two randomised trials have taken on this comparison [1, 2]. Both have inadequate numbers of patients to reach any meaningful conclusion, but for the numbers that have been examined no difference in recurrence was seen for either approach. The most recent trial failed to recruit adequate numbers despite the trial being multicentre, indeed multinational, and running for many years. Herein lies the problem with such trials. Surgeons are inclined to individualise when it comes to approach, with the perineal procedure, perhaps done under regional anaesthetic, reserved for elderly frail patients, and the abdominal approach indicated for younger patients who can tolerate a more invasive procedure and have potentially many more years of life. Equipoise does not therefore exist, and any trial becomes very difficult to recruit to. But perhaps it is time for a readjustment of this surgical dogma; the advent of laparoscopic techniques means that elderly patients can undergo abdominal procedures without an increase in complications [3]. If we assume the decision has been made to carry out an abdominal approach, is there any evidence to suggest how to carry out the operation? In terms of recurrence there probably is not. However, one large reasonably welldesigned trial has shown that the rectum cannot simply bemobilised; it has to be fixed to reduce recurrence [4]. However, recurrence is not the only important outcome. For instance, in terms of recovery, it is clear that a laparoscopic approach results in shorter postoperative stay and actually reduces overall costs [5]. Constipation is another important outcome, and the common perception is that abdominal rectopexy alone will increase the incidence of constipation in many patients, justifying the need for resection to be combined with the rectopexy [6]. Is this true? Is the added possibility of anastomotic breakdown, even if rare, really worth the risk? The study by El Muhtaseb et al. [7] would suggest it is not, with resection rectopexy failing to correct abnormal transit Comment on El Muhtaseb et al.: Colonic transit before and after resection rectopexy for full-thickness rectal prolapse (doi:10.1007/s10151-013-1053-4)." @default.
• W2012889851 created "2016-06-24" @default.
• W2012889851 creator A5035438684 @default.
• W2012889851 date "2013-10-01" @default.
• W2012889851 modified "2023-09-23" @default.
• W2012889851 title "The evidence base for rectal prolapse surgery: is resection rectopexy worth the risk?" @default.
• W2012889851 cites W1975183559 @default.
• W2012889851 cites W1989526726 @default.
• W2012889851 cites W2004144322 @default.
• W2012889851 cites W2007053035 @default.
• W2012889851 cites W2013157813 @default.
• W2012889851 cites W2087776826 @default.
• W2012889851 cites W2131274844 @default.
• W2012889851 cites W2144823457 @default.
• W2012889851 cites W2148252156 @default.
• W2012889851 doi "https://doi.org/10.1007/s10151-013-1077-9" @default.
• W2012889851 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/24081547" @default.
• W2012889851 hasPublicationYear "2013" @default.
• W2012889851 type Work @default.
• W2012889851 sameAs 2012889851 @default.
• W2012889851 citedByCount "6" @default.
• W2012889851 countsByYear W20128898512014 @default.
• W2012889851 countsByYear W20128898512015 @default.
• W2012889851 countsByYear W20128898512016 @default.
• W2012889851 countsByYear W20128898512021 @default.
• W2012889851 crossrefType "journal-article" @default.
• W2012889851 hasAuthorship W2012889851A5035438684 @default.
• W2012889851 hasBestOaLocation W20128898511 @default.
• W2012889851 hasConcept C141071460 @default.
• W2012889851 hasConcept C159110652 @default.
• W2012889851 hasConcept C2780120127 @default.
• W2012889851 hasConcept C2780365412 @default.
• W2012889851 hasConcept C2781074409 @default.
• W2012889851 hasConcept C523026621 @default.
• W2012889851 hasConcept C61434518 @default.
• W2012889851 hasConcept C71924100 @default.
• W2012889851 hasConceptScore W2012889851C141071460 @default.
• W2012889851 hasConceptScore W2012889851C159110652 @default.
• W2012889851 hasConceptScore W2012889851C2780120127 @default.
• W2012889851 hasConceptScore W2012889851C2780365412 @default.
• W2012889851 hasConceptScore W2012889851C2781074409 @default.
• W2012889851 hasConceptScore W2012889851C523026621 @default.
• W2012889851 hasConceptScore W2012889851C61434518 @default.
• W2012889851 hasConceptScore W2012889851C71924100 @default.
• W2012889851 hasIssue "3" @default.
• W2012889851 hasLocation W20128898511 @default.
• W2012889851 hasLocation W20128898512 @default.
• W2012889851 hasOpenAccess W2012889851 @default.
• W2012889851 hasPrimaryLocation W20128898511 @default.
• W2012889851 hasRelatedWork W1728980846 @default.
• W2012889851 hasRelatedWork W1973346118 @default.
• W2012889851 hasRelatedWork W2067144967 @default.
• W2012889851 hasRelatedWork W2080496114 @default.
• W2012889851 hasRelatedWork W2335456531 @default.
• W2012889851 hasRelatedWork W2368564598 @default.
• W2012889851 hasRelatedWork W2624128867 @default.
• W2012889851 hasRelatedWork W2897129811 @default.
• W2012889851 hasRelatedWork W2930986113 @default.
• W2012889851 hasRelatedWork W3136117601 @default.
• W2012889851 hasVolume "18" @default.
• W2012889851 isParatext "false" @default.
• W2012889851 isRetracted "false" @default.
• W2012889851 magId "2012889851" @default.
• W2012889851 workType "article" @default.