Evaluation of Delorme’s Procedure in the Treatment of Complete Rectal Prolapse- A Comparison with Abdominal Rectopexy (Well’s procedure)

Background: There are versatile operative techniques for treating complete rectal prolapse. Every procedure has some advantages and disadvantages. Delorme’s procedure and abdominal rectopexy (Well’s procedure) have gained more popularity. But to determine which approach is better, it is needed to evaluate the functional outcome of both procedures. Objective: To compare the outcome of Delorme’s procedure and abdominal rectopexy to treat complete rectal prolapse. Methodology: A randomized control trial was conducted in 25 patients with complete rectal prolapse in the department of Surgery, RMCH. They were divided into two groups by randomization. Fifteen patients included in Group-I underwent Delorme’s procedure, and ten patients included in group-II underwent abdominal rectopexy (Well’s procedure). The outcome of both procedures was compared postoperatively. Results: In group-1, we have found uneventful outcomes of 10 (66.66%) patients, and hemorrhage, minor incontinence, and retention of urine were found in 2(13.3%), 1(6.66), and 4(26.66%) patients, respectively. In group-2 patients, 5(50%) patients recovered uneventfully, whereas hemorrhage, surgical site infection, retention of urine, bladder dysfunction, and constipation were found in 2(20%), 1(10%), 1(10%), 1(10%) and 2(20%) patients respectively. The mean operation time in group-I was 92.86 min and in Group 2 was 124.00 min with a p-value of 0.001. The average post-operative hospital stay after Delorme’s procedure was <4 days in 4 patients and 4-6 days in the rest 11 patients. But the hospital stay is a little lengthier in the case of abdominal rectopexy (Well’s procedure), where seven patients were discharged within 4-6 days, and three patients were discharged after the 5th day of operation. In group I, expenditure was <7000 taka in 10 (66.66%) patients, whereas in group-2 , the cost was 10000-15000 in 7(70%) patients with a p-value of 0.001. Conclusion: We can conclude that Delorme’s procedure is comparatively safer and cost-effective than Well’s procedure, considering different vital parameters. TAJ 2021; 34: No-1: 40-46

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Evaluation of Clinical Outcomes after Abdominal Rectopexy and Delorme’s Procedure for Rectal Prolapse: A Prospective Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2014/7787.4353 ◽

2014 ◽

Cited By ~ 4

Author(s):

Poornachandra Thejeswi

Keyword(s):

Rectal Prolapse ◽

Prospective Study ◽

Clinical Outcomes ◽

Abdominal Rectopexy ◽

Delorme’S Procedure ◽

A Prospective Study ◽

Delorme's Procedure

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Delorme's Procedure for Complete Rectal Prolapse of Patients with Mental Disorders: Report of Three Cases

The Showa University Journal of Medical Sciences ◽

10.15369/sujms1989.11.41 ◽

1999 ◽

Vol 11 (1) ◽

pp. 41-44

Author(s):

Naokuni YASUDA ◽

Katsuo YAMAZAKI ◽

Yusuke OHASHI ◽

Yuta ENAMI ◽

Tatsuji MATSUZAWA

Keyword(s):

Mental Disorders ◽

Rectal Prolapse ◽

Complete Rectal Prolapse ◽

Delorme’S Procedure ◽

Delorme's Procedure

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Outcome of Delorme's Procedure for Full-Thickness Rectal Prolapse: Our experience in Bangabandhu Sheikh Mujib Medical University, Dhaka

Faridpur Medical College Journal ◽

10.3329/fmcj.v10i2.30271 ◽

2016 ◽

Vol 10 (2) ◽

pp. 55-58

Author(s):

Tariq Akhtar Khan ◽

Md Shahadot Hossain Sheikh ◽

Md Abu Taher ◽

Md Rayhanur Rahman ◽

Md Rashidul Islam ◽

...

Keyword(s):

Rectal Prolapse ◽

Operative Time ◽

Complete Rectal Prolapse ◽

Full Thickness ◽

Patient Reported ◽

Delorme’S Procedure ◽

The Mean ◽

Medical University ◽

Delorme's Procedure

The study was undertaken to determine the efficacy and safety profile of Delorme's procedure as the treatment for full-thickness rectal prolapse. In this study, outcome of Delorme's procedure for full-thickness rectal prolapse were assessed retrospectively. All the patients who underwent this surgery (22 patients) from July, 2013 to June, 2015 were included in the study. There were 18 males and 4 females with mean age of 37.4 years (range 12-70). The mean operative time was 92.6 minutes (Range 60-180 minutes). 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 and no patient reported recurrence of the disease within the follow up period. Delorme's operation is safe and effective treatment for complete rectal prolapse in patients of all age and sex.Faridpur Med. Coll. J. Jul 2015;10(2): 55-58

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Delorme’s Procedure for Complete Rectal Prolapse: A Study of Recurrence Patterns in the Long Term

Surgery Research and Practice ◽

10.1155/2015/920154 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Carlos Placer ◽

Jose M. Enriquez-Navascués ◽

Ander Timoteo ◽

Garazi Elorza ◽

Nerea Borda ◽

...

Keyword(s):

Risk Factors ◽

Rectal Prolapse ◽

Recurrence Rate ◽

Complete Rectal Prolapse ◽

Kaplan Meier ◽

Delorme’S Procedure ◽

Recurrence Patterns ◽

Delorme's Procedure

Introduction. The objective of this study was to determine the recurrence rate and associated risk factors of full-thickness rectal prolapse in the long term after Delorme’s procedure.Patients and Methods. The study involved adult patients with rectal prolapse treated with Delorme’s surgery between 2000 and 2012 and followed up prospectively in an outpatient unit. We assessed epidemiological data, Wexner constipation and incontinence score, recurrence patterns, and risk factors. Data were analyzed by univariate and multivariate studies and follow-up was performed according to Kaplan-Meier technique. The primary outcome was recurrence.Results. A total of 42 patients, where 71.4% (n=30) were women, with a median age of 76 years (IQR 66 to 86), underwent Delorme’s surgery. The median follow-up was 85 months (IQR 28 to 132). There was no mortality, and morbidity was 9.5%. Recurrence occurred in five patients (12%) within 14 months after surgery. Actuarial recurrence at five years was 9.9%. According to the univariate analysis, constipation and concomitant pelvic floor repair were the only factors found to be associated with recurrence. Multivariate analysis showed no statistically significant differences among variables studied. Kaplan-Meier estimate revealed that constipation was associated with a higher risk of recurrence (log-rank test,p=0.006).Conclusions. Delorme’s procedure is a safe technique with an actuarial recurrence at five years of 9.9%. The outcomes obtained in this study support the performance of concomitant postanal repair and levatorplasty to reduce recurrences. Also, severe constipation is associated with a higher recurrence rate.

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Four Patients with Complete Rectal Prolapse Treated by Delorme's Procedure.

Nippon Daicho Komonbyo Gakkai Zasshi ◽

10.3862/jcoloproctology.50.204 ◽

1997 ◽

Vol 50 (3) ◽

pp. 204-208 ◽

Cited By ~ 1

Author(s):

A. Tsunoda ◽

M. Shibusawa ◽

H. Choh ◽

R. Zhang ◽

M. Kusano ◽

...

Keyword(s):

Rectal Prolapse ◽

Complete Rectal Prolapse ◽

Delorme’S Procedure ◽

Delorme's Procedure

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Outcome of Laparoscopic Versus Open Abdominal Rectopexy for the Treatment of Complete Rectal Prolapse-Our experience in Bangabandhu Sheikh Mujib Medical University

Journal of Surgical Sciences ◽

10.3329/jss.v19i1.43769 ◽

2019 ◽

Vol 19 (1) ◽

pp. 3-7

Author(s):

Kazi Nasid Naznin ◽

Md Shahadot Hossain Sheikh ◽

Md Ahsan Habib ◽

Md Rashidul Lslam ◽

Ariful Alam ◽

...

Keyword(s):

Rectal Prolapse ◽

Subjective Assessment ◽

Complete Rectal Prolapse ◽

Laparoscopic Rectopexy ◽

Group I ◽

Abdominal Rectopexy ◽

Study Population ◽

The Mean ◽

Group Ii ◽

Medical University

Background: Complete rectal prolapse is a very distressing condition. In adults, the only potentially curative treatment for complete rectal prolapse is surgery either by transabdominal or perinea! approaches. Till date abdominal rectopexy is considered as the standard surgical treatment for complete rectal prolapse, which can be done laparoscopically or by open procedure. Objective: The purpose of the study was to observe the outcome of Laparoscopic rectopexy in the treatment of complete rectal prolapse by subjective assessment and to compare the result with that of conventional open abdominal rectopexy. Methodology: This randomized clinical trial was carried out in the Department of Surgery at Bangabandhu Sheikh Mujib Medical University, Dhaka, from July 2012 to June 2014 for a period of twenty four (24) months. Patients who presented with complete rectal prolapse with age ranging from 25 to 70 years irrespective of gender were selected as study population. Patients were randomized by lottery method into two groups as group I who underwent laparoscopic rectopexy (LR) and group II who underwent open rectopexy (OR). Result: A total number of 50 patients were recruited in this study of which 25 patients were. in group I and 25 patients were in group II. The mean (s.d.) age was 49.40 (13.22) years and 46.48(13.27) years in group I and group II respectively (p>0.05). The mean (s.d.) operative time was 115(19) minutes in group I and 75(12) minutes in group II (p<0.05). In this study 1(4.0%) patient and 6 (24.0%) patients had abdominal wound infection in group I and in group II respectively (p>0.05). Mean (s.d.) ambulation time was 1.96 (0.67) days in group I and 3.92(1.15) days in groups II (p<0.05). Postoperative hospital stay mean (s.d.) was 3.08(1.18) days in group I and 8.16(3.57) days in group II (p<0.05). Overall patients satisfaction were 92% and 76% in group I and group II respectively (p>0.05). Conclusion: Laparoscopic rectopexy is a better option than conventional open abdominal rectopexy for the treatment of complete rectal prolapse. Journal of Surgical Sciences (2015) Vol. 19 (1) : 3-7

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

Journal of the Korean Society of Coloproctology ◽

10.3393/jksc.2012.28.1.13 ◽

2012 ◽

Vol 28 (1) ◽

pp. 13 ◽

Cited By ~ 7

Author(s):

Sooho Lee ◽

Bong-Hyeon Kye ◽

Hyung-Jin Kim ◽

Hyeon-Min Cho ◽

Jun-Gi Kim

Keyword(s):

Rectal Prolapse ◽

Complete Rectal Prolapse ◽

Delorme’S Procedure ◽

Delorme's Procedure

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Modified Stapled Transanal Rectal Resection Procedure for Limited Rectal Prolapse: A Viable Alternative to the Delorme Operation

Surgical Innovation ◽

10.1177/1553350620929470 ◽

2020 ◽

pp. 155335062092947

Author(s):

Hua-Xian Chen ◽

Zu-Qing Chen ◽

Liang Huang ◽

Chang-Peng Han ◽

Ruo-Xu Dou ◽

...

Keyword(s):

Blood Loss ◽

Rectal Prolapse ◽

Operative Time ◽

Rectal Resection ◽

Stapled Transanal Rectal Resection ◽

Significant Difference ◽

Delorme’S Procedure ◽

Group 2 ◽

Delorme's Procedure ◽

Group 1

Purpose. The optimal surgical approach for full-thickness rectal prolapse (FTRP) remains controversial. In China, patients with limited FTRP (<5 cm in length) are usually managed by perineal surgery. We retrospectively assessed the outcome of Delorme’s procedure and compared it with modified stapled transanal rectal resection (STARR). Methods. The study was conducted in 2 public tertiary referral centers in China with modified STARR or Delorme's procedure performed by experienced surgeons. Outcomes assessed recurrence, operative times, blood loss, complications, length of hospital stay, and continence and constipation scoring. Results. Between December 2012 and May 2019, 65 patients were assessed, including 48 with modified STARR (group 1) and 17 with Delorme’s procedure (group 2). The median follow-up was 22 months (range, 3-86 months). The mean operative time for group 1 was 37.4 ± 17.5 minutes vs 74.3 ± 30.6 minutes for group 2 ( P < .001). The blood loss for group 1 was significantly lower than that for group 2 (17.4 ± 15.9 mL vs 27.8 ± 16.7 mL, respectively; P = .028). There was no significant difference between groups in recurrence (group 1 18.8% vs group 2 23.5%; P = .944) with no effect of operation type. Both procedures showed improvement in constipation and continence scoring with a similar impact. Conclusions. Modified STARR and the Delorme operation are comparable in managing limited FTRP with superior results in operative time and blood loss for STARR.

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