Long-term clinical outcome of surgery for XXXX .

@entity1 @entity1066 @entity322 @entity254
BACKGROUND: When severe symptoms of @entity1066 persist despite medical management, surgery may be necessary. METHODS: A retrospective review was carried out of 81 @entity1 undergoing surgery for @entity1066 in the 10-year period from 1984 to 1993 to determine the long-term outcome at a minimum follow-up of 12 months. Of the 81 @entity1 , 15 were excluded from further analysis (11 were followed up for less than 12 months, two died and two were lost to follow-up). Sixty-six @entity1 were studied (median age 38 (range 15-77) years; 53 female). Of these, 49 underwent rectopexy, nine Delorme's operation, two anterior resection and four creation of a stoma as the initial operation. RESULTS: At a median follow-up of 90 (range 12-177) months, the rectopexy had failed in 22 of 49 @entity1 ; 19 of these @entity1 underwent further surgery, including rectal resection with coloanal @entity254 (four with three failures), colostomy (11) and other procedures (four). Ultimately, 14 required a stoma. Constipation was the indication for a stoma in nine of the 11 @entity1 who had colostomy as the first procedure after failure of rectopexy. Nine @entity1 had Delorme's operation as the first procedure. At median follow-up of 38 (range 19-107) months, there were four failures. Two of these ultimately required a stoma. Of the seven @entity1 who underwent anterior resection as the initial or subsequent procedure, a stoma was finally necessary in four. Anterior resection used as a salvage procedure was not successful. The overall stoma rate was 30 per cent (20 @entity1 ). Of 11 symptoms assessed before operation only @entity322 and incomplete evacuation were related to a poor outcome following surgery. CONCLUSION: Antiprolapse operations result in a satisfactory long-term outcome in about 55-60 per cent of @entity1 having surgery for @entity1066 . Results of anterior resection are disappointing.
