Comparison of Delorme-Thiersch Operation Outcomes in Men and Women With Rectal Prolapse

Hyun, Keehoon; Yoon, Seo-Gue

doi:10.3393/ac.2018.10.15.1

Cited by 6 publications

(6 citation statements)

References 19 publications

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“…Previous studies reported that the rate of recurrence after Delorme’s procedure ranged from 9.6% to 29.7% [ 6 , 8 , 13 - 15 , 18 - 21 ]. The rate of recurrence in this current study was 27.1%, which is relatively higher than previous reports.…”

Section: Discussionmentioning

confidence: 99%

“…Multivariable Cox proportional hazards regression models were subsequently fitted to evaluate factors independently associated with RFT. Patient age, sex, length of the prolapsed rectum, and variables found to have a P-value of < 0.20 in univariate analysis were included in the multivariate analysis models [ 8 , 13 , 14 ]. Results are presented as hazard ratios (HRs) and 95% confidence intervals (CIs).…”

Section: Methodsmentioning

confidence: 99%

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Longer prolapsed rectum length increases recurrence risk after Delorme’s procedure

et al. 2022

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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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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Longer prolapsed rectum length increases recurrence risk after Delorme’s procedure

et al. 2022

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“…For this reason, the Thiersch operation is usually performed in addition to other surgical procedures. A modified Gant–Miwa–Thiersch procedure [ 18 ] and the Delorme–Thiersch operation [ 19 ] for rectal prolapse were reported with recurrence rates of 7.5% and 7.8%, respectively. Therefore, an additional Thiersch operation, among other procedures, is effective for both decreasing the incidence of recurrence for rectal prolapse and improving fecal incontinence.…”

Section: Discussionmentioning

confidence: 99%

Perineal stapled prolapse resection in combination with Thiersch operation for relapsed rectal prolapse: a case report

et al. 2021

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Background Treatment options for complete rectal prolapse include over 100 procedures. In previous reports, operative rectal prolapse repair, regardless of the technique by perineal approach, was associated with high recurrence rates. However, there is no consensus on the optimal surgical procedure for relapsed rectal prolapse. Case presentation A 97-year-old woman was admitted to our hospital with a chief complaint of complete rectal prolapse measuring > 5 cm. The patient had a history of laparoscopic anterior suture rectopexy without sigmoid resection under general anesthesia for complete rectal prolapse one year prior. The patient’s postoperative course was uneventful. However, her dementia worsened (Hasegawa’s dementia scale: 5/30 points) after the first operation. Further, moderate-to-severe aortic valve stenosis was first diagnosed with heart failure 6 months after the operation. Nine months after the initial surgery, she experienced a recurrence of complete rectal prolapse measuring approximately 5 cm. Considering the coexistence of advanced age, severe dementia, and aortic valve stenosis, surgery under general anesthesia was not indicated. Perineal stapled prolapse resection in combination with the t operation was planned because of its minimal invasiveness and shortened hospital stay. The procedure was performed by a team of two surgeons in the jack knife position, under spinal anesthesia. The prolapse was cut along the long-axis direction with three linear staplers and resected along the short-axis direction with four linear staplers. The cross-section of the linear stapler was reinforced with 3-0 Vicryl sutures. After rectal resection, the Thiersch operation using 1-0 nylon thread 1 cm away from the anal verge was additionally performed. The operative time was 24 min, and intraoperative blood loss was 1 mL. The postoperative course was uneventful. Three months after the operation, no recurrence was observed, and defecation function was good with improvements of Wexner score. Conclusions Perineal stapled prolapse resection in combination with the Thiersch operation could be a useful option for patients with relapsed rectal prolapse and with poor general condition, who are not indicated for other surgical procedures.

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“…All meshes used were made of polypropylene materials. Perineal approach included Delorme procedure, Thiersch procedure, Delorme with Thiersch procedure, and Altemeir procedure [ 18 19 20 21 22 ]. With a Thiersch procedure, a non-absorbable suture material was placed circumferentially around the anus, allowing an index finger to pass through [ 22 ].…”

Section: Methodsmentioning

confidence: 99%

“…With a Thiersch procedure, a non-absorbable suture material was placed circumferentially around the anus, allowing an index finger to pass through [ 22 ]. The Delorme with Thiersch procedure was mainly performed in Song Do Hospital (Seoul, Korea) [ 20 ]. After the Delorme procedure, a polyester tape (Cervix set, B Braun, S.A., Rubí, Spain) was brought through the tunnel around the external anal sphincter to encircle the anal canal.…”

Section: Methodsmentioning

confidence: 99%

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

Hong

Hyun

et al. 2022

Ann Surg Treat Res

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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.

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Comparison of Delorme-Thiersch Operation Outcomes in Men and Women With Rectal Prolapse

Cited by 6 publications

References 19 publications

Longer prolapsed rectum length increases recurrence risk after Delorme’s procedure

Longer prolapsed rectum length increases recurrence risk after Delorme’s procedure

Perineal stapled prolapse resection in combination with Thiersch operation for relapsed rectal prolapse: a case report

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

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