Altemeier Procedure for Complete Rectal Prolapse: An Operation for all Ages and its Long-Term Functional Outcomes

Abstract Objective The aim of this study is to evaluate the long-term functional outcomes in patients treated by Altemeier's procedure for complete rectal prolapse. Methods Records of 40 patients who underwent Altemeier's procedure for complete rectal prolapse between January 2013 to June 2023 were analyzed. The median duration of post operative follow-up was 48 months (ranges- 6 months to 10 years). Postoperatively, fecal incontinence, constipation and recurrence were analyzed. Results The median age was 45 (13-75) years. The male-to-female ratio was 1.4:1. Among forty patients, five patients had recurrent rectal prolapse. Out of forty, nine patients underwent emergency Altemeier's procedure. The median time taken for the procedure was 120 (80-155) minutes. The median postoperative length of hospital stay was 9 days. Three patients (7.5%) had Grade I anastomosis leak. All patients subsequently developed anastomotic stricture and were managed with periodic anal dilatation. There was no mortality. Postoperatively, constipation reduced from 25% to 7.5% and fecal incontinence reduced from 37.5% to 10%. There was no recurrence in our study. Conclusion The Altemeier procedure is a safe and effective procedure in both elderly and young patients presenting with complete rectal prolapse. It was associated with minimal morbidity and good long-term functional outcomes.