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

摘要

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.