LAUSR

Full-thickness rectal prolapse (FTRP) is a multifactorial disease; the dominant cause is different in each case. The authors developed an original algorithm for qualifying patients for perineal or abdominal approach based on identification of dominant factor. The validity of the algorithm was assessed by treatment results. The study aimed to assess the results and patients’ quality of life after FTRP surgery qualified for various procedures, based on a uniform algorithm. Consecutive 61 patients qualified for surgery due to FTRP from January 2012 and March 2019 were enrolled. The authors qualified for abdominal or perineal approach following a uniform algorithm. The following parameters were assessed before operation and each year after the surgery: constipation, incontinence, EuroQol 5 dimensions (EQ5D), and quality of life scale (QoL). Median follow-up period was 26 months. Investigators compared preoperative assessment and the last obtained follow-up assessment. Recurrence was observed in 5 patients (8.2%); constipation decreased from 41 patients (67.2%) before the surgery to 16 (26.2%) postoperatively. Incontinence score decreased by 51% in postoperative assessment. The Wexner score decreased from 11.7 points before to 6.3 after surgery ( p  < 0.001). No complications were observed. The QoL improved from 49.8 to 69.8 points after surgery ( p  < 0.001), and the EQ5D improved from 7.3 to 4 points ( p  < 0.001). The quality of patients’ life, after full-thickness rectal prolapse procedures qualified for surgery according to the proposed algorithm, improved in terms of all measured parameters. The small group requires further studies to confirm the utility of the algorithm.