Introducere. Prolapsul rectal este caracterizat prin exteriorizarea intermitentă sau permanentă a peretelui rectal prin canalul anal. Numărul mare de procedee chirurgicale folosite în tratamentul maladiei, reflectă multitudinea problemelor ridicate, în special gradul înalt de recidivă şi simptomele persistente. Scopul lucrării. Sinteza literaturii şi stabilirea particularităţilor de diagnostic şi tratament al prolapsului rectal. Material şi metode. Studiu descriptiv retrospectiv. Metodele de diagnostic şi tratament au fost studiate la 37 de pacienţi (vârsta:60 [23-78] ani) care au fost internaţi în Spitalul Clinic Republican, secţia chirurgie colorectală (2007-2016). Au fost colectate date medicale conform unui chestionar special elaborat, referitoare la caracteristicile pacientului, simptomatica la internare, metodele instrumentale de diagnostic utilizate, procedura chirurgicală practicată, complicaţiile post-operatorii, durata de spitalizare post-operatorie. Rezultate. 20 pacienţi (54%) au fost investigaţi prin irigoscopie, 12 pacienţi (32%) prin fibrocolonoscopie, și 21 pacienţi (57%) prin sfincterometrie anală. 35 de pacienţi (95%)au fost operaţi, 26 de pacienţi (74%) prin abord abdominal, toţi prin operaţia Kummel, iar 9 pacienţi (26%) prin abord perineal, 6 (17%) prin rezecţia mucoasei în palete şi 3 (9%) prin rezecţia transperineală a rectului. Complicaţii post-operatorii precoce au survenit într-un caz (2,7%). Durata de spitalizare medie a fost mai mică după procedurile perineale (8,75 zile) faţă de cele abdominale (11,5 zile). Concluzii. Diagnosticul prolapsului rectal este preponderent clinic, dar apariţia unor semne de alarmă sau prevalenţa unor simptome, se impun metodele instrumentale. Abordul abdominal este mai preferat din cauza recidivei mai scăzute însă cel perineal va fi folosit la un pacient cu risc mai mare şi bărbaţilor tineri pentru evitarea disfunţiilor sexuale.

Introduction. Rectal prolapse is characterized by the intermitent or permanent exteriorisation of rectal wall through the anal canal. A big number of surgical procedures used in the treatment of the illness, reflect the multitude of problems, especially the high degree of recurrence and persistence of symptoms. Objective of the study. Synthesis of literature and establishment of particularities of the diagnosis and treatment of rectal prolapse. Material and methods. Retrospective descriptive study. The diagnosis and treatment methods were studied in 37 patients (age: 60 [23-78] years) that were hospitalized in the Republican Clinical Hospital, department of colorectal surgery (2007-2016). Medical data were collect in accordance with a specially developed questionnaire, related to patient characteristics, symptoms at presentation, instrumental diagnostic methods, surgical procedure, post-operative complications and post-operative length of hospitalization. Results. 20 patients (54%) were investigated by irrigoscopy, 12 patients (32%) by fibrocolonoscopy, and 21 patients (57%) by anal sphincterometry. 35 patients (95%) were operated, 26 patients (74%) by abdominal approach, all by Kummel procedure and 9 patients (26%) by perineal approach, 6 (17%) by mucosal resection in pallets and 3 (9%) by transperineal resection of the rectum. Early post-operative complications occurred in one case (2.7%). The average hospitalization was shorter with perineal procedures (8.75 days) than with abdominal procedures (11.5 days). Conclusions. Diagnosis of rectal prolapse is predominantly clinical, but at apparition of alarme signs or the prevalence of some symptoms, instrumental methods are required. Abdominal approach is more preferred due to lower recurrence but perineal will be used at higher-risk patients and in young men to avoid sexual dysfunction.