Delorme's Procedure for Rectal Prolapse

Tsunoda, Akira; Yasuda, Naokuni; Yokoyama, Noboru; Kamiyama, Goichi; Kusano, Mitsuo

doi:10.1007/s10350-004-6724-9

Cited by 66 publications

(16 citation statements)

References 32 publications

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“…Many reports in the literature show that the Delorme operation improves continence (Table 4) [1, 3, 4, 7, 8, 10, 14]. In the present study, improved continence occurred in 63.2% of the patients who described incontinence before surgery.…”

Section: Discussionsupporting

confidence: 66%

“…The advantages of the Delorme's procedure versus abdominal techniques for the management of the rectal prolapse include 1) low morbidity and mortality [1, 7, 8], 2) no risk of impotence, which is in contrast with the abdominal rectopexy where pelvic nerves (erection problems) or hypogastric nerves (ejaculation problems) may be damaged [1, 2], 3) the feasibility of using spinal anesthesia, 4) short hospital stay, 5) early oral feeding (depending on the patients' associated conditions), and 6) patient comfort, with little or no postoperative pain. Thus, the Delorme's procedure may be recommended both for young and adult males to prevent potential impotence and for weakened or elderly patients [2].…”

Section: Discussionmentioning

confidence: 99%

“…Although there are more than a hundred techniques, including the transabdominal and the perineal approaches, for the repair of the rectal prolapsed, none of them is perfect. According to the literature, the procedure most commonly performed in the management of the rectal prolapse is the abdominal rectopexy [1]. …”

Section: Introductionmentioning

confidence: 99%

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Delorme's Procedure for Complete Rectal Prolapse: Does It Still Have It's Own Role?

Lee

Kye

Kim

et al. 2012

J Korean Soc Coloproctol

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PurposeAlthough there are more than a hundred techniques, including the transabdominal and the perineal approaches, for the repair of the rectal prolapsed, none of them is perfect. The best repair should be chosen not only to correct the prolapse but also to restore defecatory function and to improve fecal incontinence throughout the patient's lifetime. The aim of this retrospective review is to evaluate clinical outcomes of the Delorme's procedure for the management of the complete rectal prolapse.MethodsA total of 19 patients (13 females and 6 males) with complete rectal prolapses were treated by using the Delorme's procedure in St. Vincent's Hospital, The Catholic University of Korea, from February 1997 to February 2007. Postoperative anal incontinence was evaluated using the Cleveland Clinic Incontinence Score.ResultsAll 19 patients had incontinence to liquid stool, solid stool, and/or flatus preoperatively. Three (15.8%) patients reported recurrence of the rectal prolapse (at 6, 18, 29 months, respectively, after the operation). Information on postoperative incontinence was available for 16 of the 19 patients. Twelve of the 16 patients (75%) reported improved continence (5 [31.3%] were improved and 7 [43.7%] completely recovered from incontinence) while 4 patients had unchanged incontinence symptoms. One (6.3%) patient who did not have constipation preoperatively developed constipation after the operation.ConclusionThe Delorme's procedure is associated with a marked improvement in anal continence, relatively low recurrence rates, and low incidence of postoperative constipation. This allows us to conclude that this procedure still has its own role in selected patients.

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Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Delorme's Procedure for Complete Rectal Prolapse: Does It Still Have It's Own Role?

Lee

Kye

Kim

et al. 2012

J Korean Soc Coloproctol

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“…A meta-analysis including 17 publications (Delorme [2,5,6,8,9,12,13,25]; (Laparoscopic) Resection Rectopexy [1,3,4,7,14,26-28]) showed recurrence rates ranging from 10% to 30% (Delorme’s procedure) and from 0% to 11% (laparoscopic resection rectopexy) (Table 3). Based on these data, we assume a recurrence rate 2 years after randomization of 20% for the Delorme’s procedure and 5% for resection rectopexy, respectively.…”

Section: Methodsmentioning

confidence: 99%

“…The aims of the operation are to correct the rectal prolapse, to restore normal bowel function, and to avoid a recurrence of full-thickness rectal prolapse. For many patients, constipation and fecal incontinence improve after surgery [4,7,8]. …”

Section: Introductionmentioning

confidence: 99%

DeloRes trial: study protocol for a randomized trial comparing two standardized surgical approaches in rectal prolapse - Delorme’s procedure versus resection rectopexy

Rothenhoefer

Herrle

Herold³

et al. 2012

Trials

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BackgroundMore than 100 surgical approaches to treat rectal prolapse have been described. These can be done through the perineum or transabdominally. Delorme’s procedure is the most frequently used perineal, resection rectopexy the most commonly used abdominal procedure. Recurrences seem more common after perineal compared to abdominal techniques, but the latter may carry a higher risk of peri- and postoperative morbidity and mortality.Methods/DesignDeloRes is a randomized, controlled, observer-blinded multicenter trial with two parallel groups. Patients with a full-thickness rectal prolapse (third degree prolapse), considered eligible for both operative methods are included. The primary outcome is time to recurrence of full-thickness rectal prolapse during the 24 months following primary surgery. Secondary endpoints are time to and incidence of recurrence of full-thickness rectal prolapse during the 5-year follow-up, duration of surgery, morbidity, hospital stay, quality of life, constipation, and fecal incontinence. A meta-analysis was done on the basis of the available data on recurrence rates from 17 publications comprising 1,140 patients. Based on the results of a meta-analysis it is assumed that the recurrence rate after 2 years is 20% for Delorme’s procedure and 5% for resection rectopexy. Considering a rate of lost to follow-up without recurrence of 30% a total of 130 patients (2 x 65 patients) was calculated as an adequate sample size to assure a power of 80% for the confirmatory analysis.DiscussionThe DeloRes Trial will clarify which procedure results in a smaller recurrence rate but also give information on how morbidity and functional results compare.Trial registrationGerman Clinical Trial Number DRKS00000482

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Fecal Incontinence After Rectal and Perianal Surgery

Thorson¹

Urinary and Fecal Incontinence

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Delorme's Procedure for Rectal Prolapse

Abstract: Delorme's procedure had a low morbidity, did not lead to constipation, improved anal continence, and had a reasonably low recurrence rate. Improved anal sphincter and rectal sensation were associated with a reduced incidence of defecatory problems after Delorme's procedure.

Cited by 66 publications

References 32 publications

Delorme's Procedure for Complete Rectal Prolapse: Does It Still Have It's Own Role?

Delorme's Procedure for Complete Rectal Prolapse: Does It Still Have It's Own Role?

DeloRes trial: study protocol for a randomized trial comparing two standardized surgical approaches in rectal prolapse - Delorme’s procedure versus resection rectopexy

Fecal Incontinence After Rectal and Perianal Surgery

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