Combined Aluminum Potassium Sulfate and Tannic Acid Sclerosing Therapy and Anal Encirclement Using an Elastic Artificial Ligament for Rectal Prolapse

• Published in: Diseases of the colon & rectum Vol. 57; no. 5; pp. 653 - 657
• Main Authors: ABE, Tatsuya, HACHIRO, Yoshikazu, KUNIMOTO, Masao
• Format: Journal Article
• Language: English
• Published: Hagerstown, MDc Lippincott Williams & Wilkins 01.05.2014
• Subjects: Aged, 80 and over; Alum Compounds - administration & dosage; Biological and medical sciences; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Injections; Male; Medical sciences; Operative Time; Other diseases. Semiology; Rectal Prolapse - therapy; Recurrence; Retrospective Studies; Sclerosing Solutions - administration & dosage; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Tannins - administration & dosage; Treatment Outcome; Human; Ligament; High risk; Rectal prolapse; High-risk patients; Sulfates; Anal encirclement; Inorganic element; Treatment; Anus; Gastroenterology; Digestive diseases; Intestinal disease; Potassium; Anorectal disease
• ISSN: 0012-3706; 1530-0358
• DOI: 10.1097/dcr.0000000000000087

Aluminum potassium sulfate and tannic acid is a sclerosant used for sclerosing therapy in the treatment of hemorrhoids, and a Leeds-Keio artificial ligament is a new anal-encircling material for the management of rectal prolapse. The aim of this study was to evaluate clinical data and recurrence rates in patients with rectal prolapse undergoing combined aluminum potassium sulfate and tannic acid injection and anal encirclement using the Leeds-Keio artificial ligament. This was a retrospective review of patients who underwent this procedure. This study was conducted at a community-based hospital within a specialized colorectal unit. A total of 23 patients (20 women; median age, 83 years) with full-thickness rectal prolapse underwent treatment between 2005 and 2010. The main outcome measures were morbidity and recurrence rate. The median duration of surgery was 36 minutes. Mean total injection dose of aluminum potassium sulfate and tannic acid was 30 mL. There were no postoperative deaths. Wound infection occurred in 2 patients (9%), and new or worsening symptoms of constipation after surgery occurred in 6 patients (26%). There were 3 recurrences at a median follow-up of 36 months (range, 7-86 months). Recurrence rate at 5 years was 14% (95% CI, 5%-35%). The limitations of this study include its retrospective nature, the potential for selection bias, and lack of a control group. This procedure is quick and easy to perform, with no formidable morbidity, and the recurrence rate is reasonably low. Therefore, it seems to be a reasonable alternative for rectal prolapse in frail, elderly, and high-risk patients.