Clinical outcomes of surgical management for recurrent rectal prolapse: a multicenter retrospective study

Purpose: There are few reports on outcomes following surgical repair of recurrent rectal prolapse. The purpose of this study was to examine surgical outcomes for recurrent rectal prolapse. Methods: We conducted a multicenter retrospective study of patients who underwent surgery for recurrent rectal prolapse. This study used data collected by the Korean Anorectal Physiology and Pelvic Floor Disorder Study Group. Results: A total of 166 patients who underwent surgery for recurrent rectal prolapse were registered retrospectively between 2011 and 2016 in 8 referral hospitals. Among them, 153 patients were finally enrolled, excluding 13 patients who were not followed up postoperatively. Median follow-up duration was 40 months (range, 0.2-129.3 months). Methods of surgical repair for recurrent rectal prolapse included perineal approach (n = 96) and abdominal approach (n = 57). Postoperative complications occurred in 16 patients (10.5%). There was no significant difference in complication rate between perineal and abdominal approach groups. While patients who underwent the perineal approach were older and more fragile, patients who underwent the abdominal approach had longer operation time and admission days (P < 0.05). Overall, 29 patients (19.0%) showed re-recurrence after surgery. Among variables, none affected the re-recurrence. Conclusion: For the recurrent rectal prolapse, the perineal approach is used for the old and fragile patients. The postoperative complications and re-recurrence rate between perineal and abdominal approach were not different significantly. No factor including surgical method affected re-recurrence for recurrent rectal prolapse. [Ann Surg Treat Res 2022;102(4):234-240]N

What are patient factors associated with the quality of diabetes care?: results from the Korean National Health and Nutrition Examination Survey

<p>Abstract</p> <p>Background</p> <p>Recently there has been a growing interest in healthcare quality control in Korea. We examined the association between patient factors and quality indicators of diabetic care among Korean adults with diabetes.</p> <p>Methods</p> <p>We obtained a sample of 335 adults aged 20 or older diagnosed with diabetes from the 2005 Korean National Health and Nutrition Examination Survey. Patient factors were divided into two categories: socioeconomic position and health-related factors. Quality indicators for diabetes care were defined as receiving preventive care services for diabetes complications (e.g., fundus examination, microalbuminuria examination, diabetes education) and diabetes-related clinical outcomes (e.g., HbA1c, blood pressure, LDL-cholesterol). We performed multiple logistic regression analyses for each quality indicator.</p> <p>Results</p> <p>We found that people with lower education levels or shorter duration of diabetes illness were less likely to receive preventive care services for diabetes complications. Women or people with longer duration of diabetes were less likely to reach the glycemic target. Obese diabetic patients were less likely to accomplish adequate control of blood pressure and LDL-cholesterol.</p> <p>Conclusions</p> <p>Several factors of patients with diabetes, such as education level, duration of illness, gender, and obesity grade are associated with the quality of diabetes care. These findings can help inform policy makers about subpopulations at risk in developing a public health strategy in the future.</p