Perineal Approach for Rectal Prolapse

Gant-Miwa Operation with Thiersch Wiring

Abstract

As a primary operation for complete rectal prolapse, Gant-Miwa operation (perineal plication method of prolapsed rectal mucosa) with Thiersch wiring was performed on 19 patients. The postoperative results were studied and the value of this procedure was assessed. Mortality was nil after operation. Anal bleeding due to necrotic mucosa of sutu-re ligature occurred in one patient (5%) 7 days postoperatively. Three patients died of unrelated diseases, and no recurrence of rectal prolapse was recognized while they were alive. Two patients were lost to follow up. Two patients (14%) recurred 50 days and 6 years, respectively, after surgical intervention. The other 12 patients were almost completely satisfied with the operative results. However, soiling and perianal eczema after operation were disappointing in some cases.
Gant-Miwa operation with Thiersch wiring was attested to be technically simple, safe and effective with scarce complication and recurrence. This procedure is of first choice to patients with complete rectal prolapse, irrespective of their age and risk.