SynthesisBJS open2022
Abdominal versus perineal approach for external rectal prolapse: systematic review with meta-analysis.
Synthesis in BJS open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- [Surgery of rectal prolapse : Which treatment procedure for which patient?]Chirurgie (Heidelberg, Germany) · 2025Pooled it
- Comparison between perineal and abdominal approaches for the surgical treatment of recurrent external rectal prolapse: a systematic review and meta-analysis.International journal of colorectal disease · 2025Pooled it
- Mesh rectopexy in rectal prolapse: toward consensus or continued controversy?Techniques in coloproctology · 2026Article
- Article
- Laparoscopic Resection Rectopexy with Transanal Specimen Extraction for Complete Rectal Prolapse: Retrospective Cohort Study of Functional Outcomes.Journal of clinical medicine · 2026Article
- Management of rectal prolapse in octogenarians: lesson learned in 13 years' experience from a high-volume center.Updates in surgery · 2025Article
- Review
- From surgical treatment to psychiatric progress in refractory obsessive-compulsive disorder: A case report.PCN reports : psychiatry and clinical neurosciences · 2025Article
- Rectal prolapse in adult patients with anorectal malformations: considerations for adult colorectal surgeons.Pediatric surgery international · 2025Review
- Comparative Outcomes of Transabdominal and Transperineal Approaches for Full-Thickness Rectal Prolapse Repair: A Fourteen-Year Retrospective Study.Gastroenterology research · 2025Article
- Managing recurrent rectal prolapse in women: a single-center study.Frontiers in surgery · 2025Article
- The Results of Transperineal Surgery for Rectal Prolapse (10-Year Experience).World journal of plastic surgery · 2025Article
- The Predictive Risk Factor of Postoperative Recurrence Following Altemeier's and Delorme's Procedures for Full-thickness Rectal Prolapse: An Analysis of 127 Japanese Patients in a Single Institution.Journal of the anus, rectum and colon · 2024Article
- Sacral Neuromodulation for defecation disorders after non oncologic pelvic surgery.International journal of colorectal disease · 2023Article
- Current diagnostic tools and treatment modalities for rectal prolapse.World journal of clinical cases · 2023Review
- A case report of largest rectal prolapse in the literature successfully treated with Altemeier's procedure.Annals of medicine and surgery (2012) · 2022Article
- [Anal Pathology in General Practice: A Syndromic Approach to Diagnosis].Acta gastroenterologica LatinoamericanaReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundExternal rectal prolapse (ERP) is a debilitating condition in which surgery plays an important role. The aim of this study was to evaluate the outcomes of abdominal approaches (AA) and perineal approaches (PA) to ERP.
methodsThis was a PRISMA-compliant systematic review with meta-analysis. Studies published between 1990 and 2021 were retrieved. The primary endpoint was recurrence at the last available follow-up. Secondary endpoints included factors associated with recurrence and function. All studies were assessed for bias using the Newcastle-Ottawa Scale and Cochrane tool.
resultsFifteen studies involving 1611 patients (AA = 817; PA = 794) treated for ERP were included, three of which were randomized controlled trials (RCTs; 114 patients (AA = 54; PA = 60)). Duration of follow-up ranged from 12 to 82 months. Recurrence in non-randomized studies was 7.7 per cent in AA versus 20.1 per cent in PA (odds ratio (OR) 0.29, 95 per cent confidence interval (c.i.) 0.17 to 0.50; P < 0.001, I2 = 45 per cent). In RCTs, there was no significant difference (9.8 per cent versus 16.3 per cent, AA versus PA (OR 0.82, 95 per cent c.i. 0.29 to 2.37; P = 0.72, I2 = 0.0 per cent)). Age at surgery and duration of follow-up were risk factors for recurrence. Following AA, the recurrence rates were 10.1 per cent and 6.2 per cent in patients aged 65 years and older and less than 65 years of age, respectively (effect size [e.s.] 7.7, 95 per cent c.i. 4.5 to 11.5). Following PA, rates were 27 per cent and 16.3 per cent (e.s. 20.1, 95 per cent c.i. 13 to 28.2). Extending follow-up to at least 40 months increased the likelihood of recurrence. The median duration of hospital stay was 4.9 days after PA versus 7.2 days after AA. Overall, incontinence was less likely after AA (OR 0.32), but constipation occurred more frequently (OR 1.68). Most studies were retrospective, and several outcomes from RCTs were not consistent with those observed in non-RCTs.
conclusionThe overall risk of recurrence of ERP appears to be higher with PA versus AA. Incontinence is less frequent after AA but at the cost of increased constipation. Age at surgery and duration of follow-up are associated with increased risk of recurrence, which warrants adequate reporting of future studies on this topic.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.