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Session:: ePosters-Mon800-M7: Benign Anorectal

EP775 - Neorectal Prolapse After Sphincter-Preserving Rectal Cancer Surgery: A Systematic Review of the literature

Monday, May 11, 2026
8:32 AM - 8:37 AM ET

    Author(s)

  • EP

    Eleni - Aigli Politaki, MD

    General Surgery Resident
    Hygeia Hospital - Node Institute
    Athens, Attiki, Greece

    Disclosure information not submitted.

    • ePoster Presenter(s)

  • Zoe Garoufalia, MD,PhD (she/her/hers)

    Colorectal Surgeon
    Hygeia Hospital
    Marousi, Attiki, Greece

    All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no relevant financial relationships.

    View ePoster

    • Author(s)

  • PA

    Paraskevi Alexakou, MD

    Consultant surgeon
    Hygeia hospital - Node Institute
    Athens, Attiki, Greece

    Disclosure information not submitted.

    • Senior Author(s)

  • CM

    Constantine Mavrantonis, MD

    Consultant Colorectal Surgeon
    Hygeia Hospital - Node Institute
    Athens, Attiki, Greece

    Disclosure information not submitted.

Purpose/Background: Neorectal prolapse is a rare but nuanced complication following sphincter-preserving rectal cancer surgery. Its true incidence, risk factors as well as treatment approach remain poorly defined, with evidence limited to case reports and small series.

Methods/Interventions: A Prisma - compliant systematic review. PubMed and Scopus were searched up to September 2025 for reports of neorectal prolapse after sphincter preserving surgery for rectal cancer. Aim was to identify risk factors, prevalence, potential treatment approaches and outcomes of patients with neorectal prolapse after sphincter preserving surgery

Results/Outcomes: 14 studies (6 from Asia, 6 from Europe and 1 from the USA), including 66 patients with neorectal prolapse, were deemed eligible for inclusion. The majority of the study population underwent intersphincteric resection of the rectum (60 patients) while transanal total mesorectal excision was utilised in the rest 6 patients. Median age ranged from 57-66 years, with a predominance of females. Neorectal prolapse occurred within the first year postoperatively (median 3-12 months). Data on surgical treatment were available in 54 out of the 66 patients: Delorme underwent 66.7% of the patients (36/54), Gant-Miwa-Thiersch 22.2% (12 / 54), Altemeier was reported only in 1 patient as well as stapled perineal prolapse resection. Abdominal repairs were reported in 4 patients - mainly involving neorectopexy procedures. No major postoperative morbidity was reported. Prolapse recurrence occurred in 8/54 cases (≈15%), within 4 to 26 months.

Conclusion/Discussion: Neorectal prolapse is a rare complication following sphincter-saving surgical procedures for rectal cancer. Delorme is the most common repair. Abdominal neorectopexies are occasional alternatives. Standardized reporting and prospective multicenter studies are needed to define risk factors, outcomes, and preventive strategies.