Delorme's procedure for complete rectal prolapse in severely debilitated patients

Oliver, Gregory C.; Vachon, Debra; Eisenstat, Theodore E.; Rubin, Robert J.; Salvati, Eugene P.

doi:10.1007/bf02076192

Cited by 87 publications

(62 citation statements)

References 10 publications

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“…In our series, the recurrence rate was quite low and it was reported at the level of 8.7 %. Although Oliver et al [23] reported a general improvement in continence, likely obtained by the plication of muscularis propria of the rectal wall, we did not assess the clinical severity of incontinence either prior or following surgery, and only in our series, manometric findings revealed no improvement in anal sphincter function in the group.…”

Section: Discussionmentioning

confidence: 60%

Rectal Prolapse in Women—Outcomes of Perineal and Abdominal Approaches

et al. 2014

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The aim of the study was to assess the clinical and functional results of surgical treatment of female patients with rectal prolapse. In the period of 2003-2010, the group of 86 female patients (mean age of 67±10) underwent surgery due to rectal prolapse. The group of 24 patients (27.9 %) suffered from mild anal incontinence. They were operated on with open sutured rectopexy (18 pts), Altemeier (45 pts) and Delorme procedure (23 pts). Prior to surgery and after operation, clinical and function results were obtained. The follow-up period amounted to 32±11 months. In perineal approaches, we found mortality in one patient (1.4 %, Delorme) and anastomotic leak in four patients (5.9 %). The recurrence rate in the perineal group was 11.8 % (eight patients). We noted one recurrence in the rectopexy group (5.6 %). The Altemeier procedure revealed the most significant impact on the function of the anal sphincter muscles and resting pressures (42±7 vs 53±9 cm H 2 O; p=0.0082). If anterior levatoroplasty was added, the benefits referred also to squeeze pressures (41±8 vs 58±9 cm H 2 O; p=0.006 and 42±10 vs 56±9 cm H 2 O; p= 0.01). In the treatment of rectal prolapse, there is still no consensus about the operation of choice. Selection of the appropriate method should be based on clinical findings and patients' comorbidities to obtain maximal benefits and minimize the postoperative risk and failures.

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Section: Discussionmentioning

confidence: 60%

Rectal Prolapse in Women—Outcomes of Perineal and Abdominal Approaches

et al. 2014

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“…They concluded that Delorme's procedure combined with sphincteroplasty seemed indicated when both clinical and physiological findings showed a concomitant severe pelvic floor dysfunction. However, many other series without sphincteroplasty have shown improvement in continence [9,[12][13][14].…”

Section: Discussionmentioning

confidence: 99%

“…Oliver et al [14] successfully performed Delorme's procedure in 41 patients. They pointed out that important pitfalls in performing the procedure were weak or absent sphincter tone, perineal descent, and previous sphincter injury.…”

Section: Discussionmentioning

confidence: 99%

Delorme’s Procedure for Full-Thickness Rectal Prolapse; Does it Alter Anorectal Function

et al. 2012

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Clinical and anorectal manometric results of Delorme's procedure for full-thickness rectal prolapse were assessed retrospectively. Thirty-seven patients with full-thickness rectal prolapse who were operated on with Delorme's procedure were included in the study. They were 11 males and 26 females with mean age of 54± 4.4 years (range 15-70 years) and mean follow-up period of 27 ± 4.6 months (15-48 months). The mean operative time was 65 ± 4.5 min (60-90 min); there was no mortality and blood loss was minimal. Mean hospital stay was 3.5 days (2-6 days). Outcomes of the procedure were satisfactory in 29 patients (78.4%). Dissatisfaction came from recurrence and persistence of fecal incontinence. Prolapse recurrence had been observed in six patients; three of them were treated by the same technique and showed no recurrence, and the others were treated by either mucosal resection (1) or abdominal resection rectopexy (2). Constipated patients showed improved symptoms in 7 of 10 cases. Of 11 patients who were incontinent preoperatively, seven patients became fully continent. Postoperatively, anorectal manometric studies (MRP, MSP, MTV, and UDV) showed significant improvement in all patients with intact RAIR. Delorme's operation, coupled with avoidance of abdominal procedures, is the treatment of choice of rectal prolapse in elderly frail patients and in patients with defecatory disorders.

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“…Oliver et al [10] performed the Delorme procedure in 41 patients who were deemed unfit for major surgery because of age or comorbidity. They found that the important difficulties in performing the procedure were weak or absent sphincter tone, perineal descent, and previous sphincter injury.…”

Section: Discussionmentioning

confidence: 99%

An Effective Perineal Procedure for the Management of Full-Thickness Rectal Prolapse

Zhai

Wang²,

Tian³

et al. 2009

Dig Surg

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Aims: To evaluate the clinical and functional outcome of transanal purse-string sutures for rectal mucosa and submucosa plus perianal suture (TAS-PAS) for the management of full-thickness rectal prolapse. Methods: The clinical data of 62 patients with full-thickness rectal prolapse treated with TAS-PAS between March 2000 and March 2008 were analyzed retrospectively. Results: No patient died. Satisfaction with surgery was high in 50 cases (80.6%), moderate in 9 cases (14.5%), and low in 3 cases (4.84%). Prolapse relapse rate was 4.84%. Anal continence improved in 82.6% of pa tients, constipation improved in 69.2%, and anal tenesmus in 86.7%. No surgery-associated constipation occurred. The mean operative time was 52 min (range 40–80). Mean hospital stay was 4 days (range 3–7). Mean patient follow-up was 17 months (range 4–36). Conclusions: From our data, TAS-PAS for the management of full-thickness rectal prolapse showed encouraging results with little complications and an acceptable relapse rate. This procedure induces only mild trauma and is easy to perform making it worthy of further practice and investigation.

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Delorme's procedure for complete rectal prolapse in severely debilitated patients

Cited by 87 publications

References 10 publications

Rectal Prolapse in Women—Outcomes of Perineal and Abdominal Approaches

Rectal Prolapse in Women—Outcomes of Perineal and Abdominal Approaches

Delorme’s Procedure for Full-Thickness Rectal Prolapse; Does it Alter Anorectal Function

An Effective Perineal Procedure for the Management of Full-Thickness Rectal Prolapse

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