PURPOSE: The aim of this study was to assess long- term outcome of Orr- Loygue rectopexy and Delorme’ s procedures in total rectal prolapse management. METHODS: Data were collected retrospectively from 1978 to 2001. Statistical analysis was performed by chi- squared test and Student’ s t - test. RESULTS: One hundred nine patients underwent either a Orr- Loygue rectopexy (49 patients) or a Delorme’ s procedure (60 patients). Mean follow- up was 88 (range, 1- 300) months. In the rectopexy group, the overall complication rate and the recurrence rate were 33 percent and 4 percent, respectively. In patients with preoperative constipation, this symptom was improved or completely resolved in 33 percent and worsened in 58 percent postoperatively. Seventy- three percent of patients with preoperative incontinence were continent or had continence improvement postoperatively. In Delorme’ s group, overall complication and recurrence rates were 15 percent and 23 percent, respectively. Mortality was 7 percent. In patients with preoperative constipation, this symtom was improved or completely resolved in 54 percent and worsened in 12.5 percent of patients postoperatively. Forty- two percent of patients with preoperative incontinence were continent or had continence improvement postoperatively. CONCLUSIONS: In this study, Orr- Loygue rectopexy had a lower long- term recurrence rate. However, this surgical procedure is associated with a higher complication rate. We believe that Delorme’ s procedure is still a valuable option in selected patients with postoperative minimal morbidity but higher recurrence rate.
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