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The perineal approach to treating full-thickness external rectal prolapse was adopted in the first attempt to cure this condition due to the risk posed by the intraperitoneal approach in the preantibiotic era and before adequate anaesthesiological support became available. The first rectosigmoidectomy reported in the literature was an emergency amputation of the rectum for an irreducible rectal prolapse with gangrene, performed by Auffret in 1882 [1]. Then in 1888, Mikulicz [2] described a series of six cases of rectal amputation for incarcerated complete rectal prolapse, with no mortality or recurrence, so that the operation was long associated to his name (as reported in Gabriel' textbook on rectal surgery, dated 1949 [3]). Following other occasional reports, Miles [4] made a detailed description of the technique in 1933, but the name of Altemeier [5] was finally linked to this operation after his paper describing his procedure on elderly and debilitated patients was published in the Archives of Surgery in 1952. [ABSTRACT FROM AUTHOR]

Fecal incontinence is a multifactorial disease. Anorectal physiology studies play an outstanding role in the evaluation of its etiology and severity, the two main factors that constitute the basis for the correct choice of treatment. However, the prognostic role of clinical factors and anorectal physiological tests in predicting the outcome to either conservative or surgical treatment is questionable. [ABSTRACT FROM AUTHOR]

The main problem in assessing anal function in patients with a neoanal sphincter, particularly those after total anorectal reconstruction following Miles' operation, is the onset of defecatory disturbance, which can sometimes be even more troublesome than anal incontinence. No QoL questionnaires have yet been drawn up for patients with obstructed defecation or combined functional disorders. There is a strong need for such a tool, which would make it possible to perform a better evaluation of the results of these newer operations and to compare different groups of patients undergoing different anal neosphincter procedures. [ABSTRACT FROM AUTHOR]