Management of the asymptomatic primary in the palliative treatment of metastatic colorectal cancer

[Operative therapy of external rectal prolapse with a stapler]

External rectal prolapse is a rare condition, which is more common in old and multimorbid women. In recent years five surgical methods have become established from among the multitude of operative procedures which have been described. One of the most recent techniques is perineal stapled prolapse resection (PSP) which is described in this article. After complete eversion of the rectal prolapse it is resected into 2 halves using a linear cutter by incisions at 3 o'clock and 9 o'clock lithotomy positions, followed by stepwise resection with a curved cutter along the ventral and dorsal circumference. There is low evidence for the treatment of external rectal prolapse. For PSP only case series exist with results that are similar to those from other techniques; however, comparative studies are nearly completely lacking. The PSP is a relatively new surgical technique for the treatment of external rectal prolapse. It is a safe surgical procedure. Due to the lack of evidence it should remain reserved for old and/or multimorbid patients.