Altemeier’s Repair for Irreducible Full-thickness Rectal Prolapse: A 2-year Experience

A BSTRACT Background: Full-thickness rectal prolapse (FTRP) requires active management. When a patient presents with irreducible FTRP accompanied by mucosal ischemic changes, emergency intervention is warranted. In such cases, perineal procedures like the Altemeier procedure, with or without a Thiersch stitch, play a pivotal role. Study: This is a retrospective study of five patients who presented with FTRP over 2 years in a single surgical unit. The role of the Altemeier procedure, its outcomes, and associated morbidity are discussed. Observations: Four out of five patients underwent emergency Altemeier procedures due to irreducibility. Two of the five patients were female, and they additionally underwent perineorrhaphy and levatoroplasty. Three patients underwent an additional Thiersch stitch. All patients were discharged on the postoperative day 7 on a full diet and were advised to perform perineal exercises. At a 2-year follow-up, no complications or recurrence were observed. Conclusion: Irreducible FTRP can be successfully managed in emergency settings using the Altemeier procedure, irrespective of age. Adjunct procedures such as levatoroplasty, perineorrhaphy, or Thiersch stitch may further enhance the outcomes.