Thiersch's Procedure for Rectal Prolapse

概要

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Anal encircling (Thiersch procedure) is one of the perineal procedures for rectal prolapse. It was first described in 1891 by Carl Thiersch. This procedure entails encircling and straightening the anal canal with a kind of cord. It was used for rectal prolapse in Japan in the 1960s. Although silver wire was the original material described by Thiersch, nowadays other materials are used: nylon thread, Teflon<SUP>®</SUP> tape or stretchable polyester tape. These variants were conceived to prevent complications, broken wire, anal or perineal erosion, and infection. However, there are many reports of a recurrence rate of over 40% with this procedure; anal encircling combined with another method such as mucosal plication (Gant-Miwa Procedure) has proven to reduce the recurrence rate. Nevertheless, the Thiersch procedure does not require general anesthesia, so it is preferred by elderly patients and those who cannot tolerate general anesthesia.