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Bhattacharya P, Hussain MI, Zaman S, Randle S, Tanveer Y, Faiz N, Sarma DR, Peravali R. Delorme's vs. Altemeier's in the management of rectal procidentia: systematic review and meta-analysis. Langenbecks Arch Surg 2023; 408:454. [PMID: 38041773 DOI: 10.1007/s00423-023-03181-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 11/15/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND Rectal prolapse is a distressing condition for patients and no consensus exists on optimal surgical management. We compared outcomes of two common perineal operations (Delorme's and Altemeier's) used in the treatment of rectal prolapse. METHODS A systematic search of multiple electronic databases was conducted. Peri- and post-operative outcomes following Delorme's and Altemeier's procedures were extracted. Primary outcomes included recurrence rate, anastomotic dehiscence rate and mortality rate. The secondary outcomes were total operative time, volume of blood loss, length of hospital stay and coloanal anastomotic stricture formation. Revman 5.3 was used to perform all statistical analysis. RESULTS Ten studies with 605 patients were selected; 286 underwent Altemeier's procedure (standalone), 39 had Altemeier's with plasty (perineoplasty or levatoroplasty), and 280 had Delorme's. Recurrence rate [OR: 0.66; 95% CI [0.44-0.99], P = 0.05] was significantly lower and anastomotic dehiscence [RD: 0.05; 95% CI [0.00-0.09], P = 0.03] was significantly higher in the Altemeier's group. However, sub group analysis of Altemeier's with plasty failed to show significant differences in these outcomes compared with the Delorme's procedure. Length of hospital stay was significantly more following an Altemeier's operation compared with Delorme's [MD: 3.05, 95% CI [0.95 - 5.51], P = 0.004]. No significant difference was found in total operative time, intra-operative blood loss, coloanal anastomotic stricture formation and mortality rates between the two approaches. CONCLUSIONS A direct comparison of two common perineal procedures used in the treatment of rectal prolapse demonstrated that the Altemeier's approach was associated with better outcomes. Future, well-designed high quality RCTs with long-term follow up are needed to corroborate our findings.
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Affiliation(s)
- Pratik Bhattacharya
- Department of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, West Midlands, UK.
| | - Mohammad Iqbal Hussain
- Department of General Surgery, Great Western Hospitals NHS Foundation Trust, Swindon, UK
| | - Shafquat Zaman
- Department of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, West Midlands, UK
| | - Sophie Randle
- Department of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, West Midlands, UK
| | - Yousaf Tanveer
- Department of General Surgery, Craigavon Area Hospital, Portadown, Northern Ireland, UK
| | - Nameer Faiz
- Department of General Surgery, The Dudley Group NHS Trust, Russells Hall Hospital, Dudley, West Midlands, UK
| | - Diwakar Ryali Sarma
- Department of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, West Midlands, UK
| | - Rajeev Peravali
- Department of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, West Midlands, UK
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Yiasemidou M, Yates C, Cooper E, Goldacre R, Lindsey I. External rectal prolapse: more than meets the eye. Tech Coloproctol 2023; 27:783-785. [PMID: 37278904 DOI: 10.1007/s10151-023-02829-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 05/29/2023] [Indexed: 06/07/2023]
Affiliation(s)
- M Yiasemidou
- Pelvic Floor Unit, Department of Colorectal Surgery, Oxford University Hospitals NHS Trust, Oxford, England
| | - C Yates
- Pelvic Floor Unit, Department of Colorectal Surgery, Oxford University Hospitals NHS Trust, Oxford, England
| | - E Cooper
- Pelvic Floor Unit, Department of Colorectal Surgery, Oxford University Hospitals NHS Trust, Oxford, England
| | - R Goldacre
- Nuffield Department of Population Health, Big Data Institute, Oxford University, Oxford, England
| | - I Lindsey
- Pelvic Floor Unit, Department of Colorectal Surgery, Oxford University Hospitals NHS Trust, Oxford, England.
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Calderón Duque AT, Cano Pecharromán EM, Broekhuizen Benítez J, Arriero Ollero L, Gómez Ruiz L, Balsa Marín T. Delorme's procedure for urgent rectal prolapse - A video vignette. Colorectal Dis 2023; 25:513-514. [PMID: 36200292 DOI: 10.1111/codi.16352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 09/25/2022] [Indexed: 12/13/2022]
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Ng YYR, Tan EJKW, Fu CWP. Trends in the surgical management of rectal prolapse: An Asian experience. Asian J Endosc Surg 2022; 15:110-120. [PMID: 34448361 DOI: 10.1111/ases.12978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 07/14/2021] [Accepted: 08/10/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Posterior compartment pelvic floor prolapse (PCPFP) leads to anatomical distortion and functional impairment. Definitive management involves surgery. Ventral mesh rectopexy (VMR) has gained increasing popularity in the West as it emerges as a durable approach. Existing literature and evidence on safety and efficacy of PCPFP surgery in the Asian population remains sparse. Our study aims to review our institution's experience in surgery for PCPFP. METHODS All cases of PCPFP surgery in Singapore General Hospital between 2014 to 2019 were studied. RESULTS Eighty-three patients had surgery performed for PCPFP, with the majority (83%) in the last 3 years. Median age was 63 years and 92% were female. Most patients (64%) had obstructive defecation symptoms, while the remaining had fecal incontinence, rectal bleeding, or anal discomfort. Main anatomical indication for surgery was external rectal prolapse (48%). Other indications were rectocele and/or rectal intussusception. The majority (66%) had abdominal rectopexy, while 28 underwent Delorme's procedure. Forty-five of the 50 VMRs were minimally invasive. Patients undergoing rectopexy were observed to be younger. Median length of stay was 3 days. Nine patients had early operative complications of which ileus was most common. Median length of follow-up was 12 months. The majority (93%) had initial symptom satisfaction. Eleven patients had anatomical recurrence with a median length of 9 months to development. There was no significant difference in outcomes between abdominal vs perineal approach, or laparoscopic vs robotic VMR. CONCLUSION Surgery for PCPFP has gained acceptance in our Asian institution with good symptom improvement, alongside low morbidity and recurrence.
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Affiliation(s)
- Yvonne Ying-Ru Ng
- Department of Colorectal Surgery, Singapore General Hospital, Singapore
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5
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Tanabe T, Yamaguchi E, Nakada T, Nishio R, Okamoto K, Yamana T. Longer Prolapsed Rectum Length Increases Recurrence Risk After Delorme's Procedure. Ann Coloproctol 2021; 38:314-318. [PMID: 34256427 PMCID: PMC9441539 DOI: 10.3393/ac.2020.01032.0147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 05/01/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose Risk factors for recurrence of rectal prolapse after surgery remain unclear. Delorme’s procedure is often selected for relatively small-sized rectal prolapse, but there are few reports discussing the association between prolapsed rectum length and prolapse recurrence after Delorme’s procedure. We hypothesized that patients with longer rectal prolapses are at a higher risk of recurrence after Delorme’s procedure. Methods The study population comprised patients with rectal prolapse who underwent Delorme’s procedure between January 2014 and December 2019 at Tokyo Yamate Medical Center. We extracted data on patient age, sex, body mass index, previous history of anal surgery, previous history of surgery for rectal prolapse, and length of prolapse, to identify risk factors for prolapse recurrence. Results Altogether, 96 patients were eligible for analysis. The median length of the prolapsed rectum was 3.0 cm (range, 1.0–6.6 cm). Twenty-four patients (25.0%) experienced recurrence after Delorme’s procedure after a median of 7.5 months (interquartile range, 3.2–20.9 months). Multivariate analysis revealed that longer prolapsed rectum length increased the risk of recurrence after Delorme’s procedure (hazard ratio, 6.28; 95% confidence interval, 1.83–21.50; P<0.001). Conclusion The length of the prolapsed rectum should be measured before Delorme’s procedure for rectal prolapse, because length is associated with a risk of recurrence after the surgery.
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Affiliation(s)
- Taro Tanabe
- Department of Coloproctology, Tokyo Yamate Medical Center, Tokyo, Japan
| | - Emi Yamaguchi
- Department of Coloproctology, Tokyo Yamate Medical Center, Tokyo, Japan
| | - Takuya Nakada
- Department of Coloproctology, Tokyo Yamate Medical Center, Tokyo, Japan
| | - Risa Nishio
- Department of Coloproctology, Tokyo Yamate Medical Center, Tokyo, Japan
| | - Kinya Okamoto
- Department of Coloproctology, Tokyo Yamate Medical Center, Tokyo, Japan
| | - Tetsuo Yamana
- Department of Coloproctology, Tokyo Yamate Medical Center, Tokyo, Japan
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Ciesielski P, Szczotko M, Kołodziejczak M. Surgical Treatment of Full-Thickness Rectal Prolapse (FTRP): a Case Series Analysis. Indian J Surg 2021. [DOI: 10.1007/s12262-020-02439-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Maldonado Marcos E, Planellas Giné P, Gil Garcia J, Farrés Coll R, Codina Cazador A. Altemeier procedure for rectal prolapse after intersphincteric low anterior resection with transanal total mesorrectal excision. Cir Esp 2020; 99:389-391. [PMID: 32564876 DOI: 10.1016/j.ciresp.2020.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 05/17/2020] [Accepted: 05/21/2020] [Indexed: 11/18/2022]
Affiliation(s)
- Eloy Maldonado Marcos
- Cirugía General y Digestiva, Unidad de Cirugía Colorrectal, Servicio de Cirugía General y del Aparato Digestivo, Universidad de Girona, Instituto de Investigación Biomédica de Girona (IdIBGi), Girona, España.
| | - Pere Planellas Giné
- Cirugía General y Digestiva, Unidad de Cirugía Colorrectal, Servicio de Cirugía General y del Aparato Digestivo, Universidad de Girona, Instituto de Investigación Biomédica de Girona (IdIBGi), Girona, España
| | - Júlia Gil Garcia
- Cirugía General y Digestiva, Unidad de Cirugía Colorrectal, Servicio de Cirugía General y del Aparato Digestivo, Universidad de Girona, Instituto de Investigación Biomédica de Girona (IdIBGi), Girona, España
| | - Ramon Farrés Coll
- Cirugía General y Digestiva, Unidad de Cirugía Colorrectal, Servicio de Cirugía General y del Aparato Digestivo, Universidad de Girona, Instituto de Investigación Biomédica de Girona (IdIBGi), Girona, España
| | - Antoni Codina Cazador
- Cirugía General y Digestiva, Unidad de Cirugía Colorrectal, Servicio de Cirugía General y del Aparato Digestivo, Universidad de Girona, Instituto de Investigación Biomédica de Girona (IdIBGi), Girona, España
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Emile SH, Elbanna H, Youssef M, Thabet W, Omar W, Elshobaky A, Abd El-Hamed TM, Farid M. Laparoscopic ventral mesh rectopexy vs Delorme's operation in management of complete rectal prolapse: a prospective randomized study. Colorectal Dis 2017; 19:50-57. [PMID: 27225971 DOI: 10.1111/codi.13399] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 04/11/2016] [Indexed: 02/08/2023]
Abstract
AIM Various surgical operations have been devised for the treatment of rectal prolapse, yet no ideal procedure has been described. The present study aims to compare the clinical and functional outcome of laparoscopic ventral mesh rectopexy (LVMR) and Delorme's operation for complete rectal prolapse. METHOD Fifty patients with complete rectal prolapse were enrolled in this study. Patients were randomly selected to undergo either LVMR or Delorme's procedure after clinical, manometric and radiological evaluation. Patient characteristics, operative data, postoperative complications, recurrence of rectal prolapse and continence state were evaluated. Patients were followed for a mean duration of 18 months. RESULTS Thirty-one (62%) patients were women and 19 (38%) patients were men with a mean age of 39.7 ± 6.9 years. Patients were allocated into two equal groups: LVMR group and Delorme's group. Thirty-three (66%) complained of faecal incontinence preoperatively. Patients were followed for 18 months. There was no major postoperative complication or treatment death. Improvement in continence was reported in 80.9% of patients (83.3% in group 1 vs 71.4% in group 2). Recurrent prolapse was observed in 16% of patients in group 2 and 8% in group 1 (P = 0.66). The operation time was significantly greater in group 1 and the length of stay greater in group 2. There was no difference in the fall of constipation score between the groups. CONCLUSION There was no statistically significant difference in the incidence of recurrence of complete rectal prolapse or postoperative improvement of symptoms between the two groups. Hospital stay was longer after Delorme's procedure but the operation time was shorter. Neither procedure proved definite superiority regarding the clinical and functional outcome at 18 months of follow-up.
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Affiliation(s)
- S H Emile
- General Surgery Department, Mansoura Faculty of Medicine, Mansoura City, Dakahlia Providence, Egypt
| | - H Elbanna
- General Surgery Department, Mansoura Faculty of Medicine, Mansoura City, Dakahlia Providence, Egypt
| | - M Youssef
- General Surgery Department, Mansoura Faculty of Medicine, Mansoura City, Dakahlia Providence, Egypt
| | - W Thabet
- General Surgery Department, Mansoura Faculty of Medicine, Mansoura City, Dakahlia Providence, Egypt
| | - W Omar
- General Surgery Department, Mansoura Faculty of Medicine, Mansoura City, Dakahlia Providence, Egypt
| | - A Elshobaky
- General Surgery Department, Mansoura Faculty of Medicine, Mansoura City, Dakahlia Providence, Egypt
| | - T M Abd El-Hamed
- General Surgery Department, Mansoura Faculty of Medicine, Mansoura City, Dakahlia Providence, Egypt
| | - M Farid
- General Surgery Department, Mansoura Faculty of Medicine, Mansoura City, Dakahlia Providence, Egypt
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Abstract
Major complications only rarely occur after rectal prolapse surgery. Generally, the spectrum of possible complications should always be considered depending on the selected surgical procedure. Minor complications in all techniques have been described in up to 36 %. The commonest complication is bleeding with 2-5 %, urinary tract infections and wound infections. Finally, the risk of recurrence must be considered, which shows substantial differences (4-40 %); therefore, no operation technique can be given preference based solely on the risk of recurrence. Therapy decisions are always more individualized and must take the personal environment of the patient as well as the experience of the surgeon into consideration.
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10
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Osman MM, Abd El Maksoud WM, Gaweesh YS. Delorme's operation plus sphincteroplasty for complete rectal prolapse associated with traumatic fecal incontinence. J Biomed Res 2015; 29:326-31. [PMID: 26243520 PMCID: PMC4547382 DOI: 10.7555/jbr.29.20140080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 08/16/2014] [Accepted: 12/25/2014] [Indexed: 01/01/2023] Open
Abstract
Rectal prolapse associated with traumatic fecal incontinence is a rare clinical combination. This study was designed to assess Delorme's operation with sphincteroplasty as a surgical management of this combination in terms of recurrence and improvement of fecal incontinence. In this prospective study, we enrolled patients suffering from short, full-thickness rectal prolapse associated with traumatic fecal incontinence who had been admitted to Alexandria Main University Hospital during the period of May 2010–January 2013. Preoperative data including cause of trauma, duration of symptoms, results of anal manometry, and degree of fecal incontinence using Wexner score were collected from all patients. Delorme's procedure with overlap sphincteroplasty was done in all patients. Recurrence of prolapse and improvement of fecal incontinence were assessed after 1, 3, 6 and 12 months. The study included 13 patients aged (32±8.7) years, 9 females and 4 males. Cause of sphincteric injury included previous anal surgery in 7 patients and normal labor in 6 patients. Duration between sphincteric injury and operation was (8.08±2.47) months. Preoperative Wexner's mean score was 16.07±3.4. Early postoperative complications included superficial wound infection (69.2%), minor wound dehiscence (61.5%), and postoperative bleeding (7.6%). Recurrence was detected in 1 patient at 6 month follow-up. Wexner's score showed significant improvement for all patients after 6 months (4.00±2.04). In conclusion, combination of Delorme's procedure and sphincteroplasty for treatment of patients with short complete rectal prolapse associated with traumatic fecal incontinence is a safe, effective surgical management with satisfactory results regarding anatomical and functional outcomes.
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Affiliation(s)
- Mohamed M Osman
- Department of General Surgery, Faculty of Medicine, University of Alexandria, Alexandria 21526, Egypt
| | - Walid M Abd El Maksoud
- Department of General Surgery, Faculty of Medicine, University of Alexandria, Alexandria 21526, Egypt.
| | - Yosry S Gaweesh
- Department of General Surgery, Faculty of Medicine, University of Alexandria, Alexandria 21526, Egypt
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Hotouras A, Ribas Y, Zakeri S, Bhan C, Wexner SD, Chan CL, Murphy J. A systematic review of the literature on the surgical management of recurrent rectal prolapse. Colorectal Dis 2015; 17:657-64. [PMID: 25772797 DOI: 10.1111/codi.12946] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 01/21/2015] [Indexed: 12/14/2022]
Abstract
AIM There are no available guidelines to support surgical decision-making in recurrent rectal prolapse. This systematic review evaluated the results of abdominal or perineal surgery for recurrent rectal prolapse, with the aim of developing an evidence-based treatment algorithm. METHOD PubMed and MEDLINE databases were searched for all clinical studies involving patients who underwent surgery for recurrent rectal prolapse between 1950 and 2014. The primary outcome measure was the recurrence rate after abdominal or perineal surgery for recurrent rectal prolapse. Secondary outcomes included morbidity, mortality and quality of life data where available. RESULTS There were no randomized controlled studies comparing the success rates of abdominal or perineal surgery for recurrent rectal prolapse. Most studies were heterogeneous, of low quality (level IV) and involved small numbers of patients. The follow-up of 144 patients included in the studies undergoing perineal surgery ranged from 8.8 to 81 months, with recurrence rates varying from 0% to 50%. Morbidity ranged from 0% to 17% with no mortality reported. Limited data on quality of life following the Altemeier procedure were available. The follow-up for 158 patients included in the studies who underwent abdominal surgery ranged from 0 to 23 years, during which recurrence rates varied from 0% to 15%. Morbidity rates ranged from 0% to 32% with 4% mortality. No quality of life data were available for patients undergoing abdominal surgery. CONCLUSION This systematic review was unable to develop a treatment algorithm for recurrent rectal prolapse due to the variety of surgical techniques described and the low level of evidence within heterogeneous studies. Larger high-quality studies are necessary to guide practice in this difficult area.
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Affiliation(s)
- A Hotouras
- Academic Surgical Unit, Royal London Hospital, London, UK.,Department of Surgery, Whittington Hospital NHS Trust, London, UK
| | - Y Ribas
- Department of Surgery, Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain
| | - S Zakeri
- Department of Surgery, Whittington Hospital NHS Trust, London, UK
| | - C Bhan
- Department of Surgery, Whittington Hospital NHS Trust, London, UK
| | - S D Wexner
- Digestive Disease Center, Cleveland Clinic Florida, Weston, FL, USA
| | - C L Chan
- Academic Surgical Unit, Royal London Hospital, London, UK
| | - J Murphy
- Physiology Unit, St Mark's Hospital, London, UK
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Steele SR, Varma MG, Prichard D, Bharucha AE, Vogler SA, Erdogan A, Rao SSC, Lowry AC, Lange EO, Hall GM, Bleier JIS, Senagore AJ, Maykel J, Chan SY, Paquette IM, Audett MC, Bastawrous A, Umamaheswaran P, Fleshman JW, Caton G, O'Brien BS, Nelson JM, Steiner A, Garely A, Noor N, Desrosiers L, Kelley R, Jacobson NS. The evolution of evaluation and management of urinary or fecal incontinence and pelvic organ prolapse. Curr Probl Surg 2015; 52:17-75. [PMID: 25919203 DOI: 10.1067/j.cpsurg.2015.01.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 01/29/2015] [Indexed: 12/13/2022]
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Makineni H, Thejeswi P, Rai BKS. Evaluation of Clinical Outcomes after Abdominal Rectopexy and Delorme's Procedure for Rectal Prolapse: A Prospective Study. J Clin Diagn Res 2014; 8:NC04-7. [PMID: 24995208 DOI: 10.7860/jcdr/2014/7787.4353] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 03/16/2014] [Indexed: 12/27/2022]
Abstract
BACKGROUND Complete rectal prolapse is characterized by protrusion of full thickness rectal wall through the anal orifice. Despite its rarity more than 100 surgical procedures have been described and there are no good evidence based recommendations for selection of a surgical procedure. This study was conducted to evaluate the clinical outcomes of commonly used procedures for rectal prolapse at our hospital. MATERIALS AND METHODS Twenty seven patients presenting with complete rectal prolapse between May 2011 to May 2013 were included in this prospective study. Patients underwent either Abdominal rectopexy or Delorme's procedure after evaluation, based on clinical judgment of experienced surgeons. Patient characteristics, complications, post-operative length of hospitalization and clinical outcomes were assessed. Patients were followed up for a mean duration of 14 months. RESULTS Seventeen patients underwent Abdominal rectopexy (Posterior mesh rectopexy), ten patients underwent Delorme's procedure. No postoperative mortalities or major complications were noted. Post operative morbidity (minor) was 17% in Abdominal rectopexy group and 10% in Delormes group 0%. Incontinence improved in all six patients (100%) in rectopexy group, four patients (80%) in Delorme's procedure group. Two patients (11%) in rectopexy group reported increase in constipation post operatively. There was one recurrence in Delorme's procedure group with no recurrences in Abdominal rectopexy group. CONCLUSION The treatment of rectal prolapse should be individualized to achieve best results. Abdominal rectopexy can be safely applied in most of patients with minimal post operative increase in constipation and recurrence by using posterior mesh rectopexy technique. Delorme's procedure can be performed with minimal morbidity and shorter hospital stay and good functional results with acceptable recurrence rate. Delorme's can be considered as an alternative to rectopexy not only in patients unfit for laparotomy but also in individuals with a short prolpase, avoiding a laparotomy.
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Affiliation(s)
- Hemanth Makineni
- Junior Resident, Department of General Surgery, Shreyas , Pragathi Coloney, Near Baliga Stores, Bejai, Managalore, India
| | - Poornachandra Thejeswi
- Associate Professor, Department of General Surgery, Shreyas , Pragathi Coloney, Near Baliga Stores, Bejai, Managalore, India
| | - B K Shivprasad Rai
- Professor, Department of General Surgery, Shreyas , Pragathi Coloney, Near Baliga Stores, Bejai, Managalore, India
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