Abstract

We presented a perineal rectosigmoidectomy (Althemeier) that was operated under local anesthesia and sedation. The patient had high risks for general anesthesia due to advanced age and co-morbid diseases. Spinal or epidural anesthesias were not suitable due to lumbal osteoarthritis and deformity. Seventy six years old woman was operated for resection of 13 cm large bowel. Anastomosis was done after pull through of the bowel and levatoroplasty was added. Operation completed by infiltration of lidocaine for local anesthesia, in addition to ketamine, fentanyl and propofol for sedation. Procedure lasted for 120 minutes and blood loss was only 50 ml. Patient started oral liquids on postoperative day one. The patient discharged on postoperative fifth day without any complication. If necessary, perineal rectosigmoidectomy for rectal prolapse can be done under local anesthesia with support of sedation. This is an important advantage of the mentioned procedure.

Key Words: Rectal Prolapse, Perineal Rectosigmoidectomy, Local Anesthesia.