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Delorme surgery for colonic mucosal prolapse after intersphincteric resection

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Abstract

Purpose

Mucosal prolapse at the site of anastomosis is a long-term complication unique to ISR. It reduces the QOL of patients due to a worsened anal function and local symptoms around the anus. We herein sought to assess the surgical outcomes after Delorme surgery for these patients.

Methods

ISR was performed in 720 patients with low rectal cancer between January 2001 and March 2019 at the National Cancer Center Hospital East. Among these patients, the 33 (4.5%) who underwent initial Delorme surgery for postoperative colonic mucosal prolapse were identified from the medical records and then were analyzed retrospectively. We estimated the anal function using Wexner’s incontinence score and assessed whether local anal symptoms due to the prolapse improved postoperatively.

Results

Stoma closure was performed before Delorme surgery in 15 (45.5%) patients, and we compared the preoperative and postoperative anal function in these patients. The average Wexner’s incontinence score changed from 15.1 before to 12.9 after Delorme surgery. Local symptoms around the anus improved in all 33 (100%) patients. Recurrence of colonic mucosal prolapse occurred in 5 patients (15%), and Delorme surgery was reperformed in these cases.

Conclusion

Delorme surgery for colonic mucosal prolapse following ISR has clinical benefits for both improving anal local symptoms and slightly improving the anal function.

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Data availability

Raw data were generated at National Cancer Center Hospital East. Derived data supporting the findings of this study are available from the corresponding author [MI] on request.

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Authors and Affiliations

  1. Department of Colorectal Surgery, National Cancer Center Hospital East, Masaaki Ito, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan

    Satoshi Narihiro, Naoko Miura, Yuji Nishizawa, Hiro Hasegawa, Koji Ikeda, Koichi Teramura, Yuichiro Tsukada, Takeshi Sasaki & Masaaki Ito

Authors
  1. Satoshi Narihiro
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  2. Naoko Miura
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  3. Yuji Nishizawa
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  4. Hiro Hasegawa
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  5. Koji Ikeda
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  6. Koichi Teramura
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  7. Yuichiro Tsukada
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  8. Takeshi Sasaki
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  9. Masaaki Ito
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Contributions

SN made substantial contributions to the conception and design, acquisition of data, and analysis and interpretation of data; NM contributed to the drafting of the manuscript and critical revision for important intellectual content; YN, HH, KI, KT, YT, TS contributed to the discussion about this study; MI gave final approval of the version to be published; All authors read and approved the final manuscript.

Corresponding author

Correspondence to Masaaki Ito.

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Conflict of interest

The authors declare that they have no conflicts of interest or financial ties to disclose.

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee, and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Consent to participate

The study was approved by the institutional review board, and all patients gave their written informed consent.

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The study was approved by the institutional review board, and all patients gave written informed consent.

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Narihiro, S., Miura, N., Nishizawa, Y. et al. Delorme surgery for colonic mucosal prolapse after intersphincteric resection. Surg Today 51, 916–922 (2021). https://doi.org/10.1007/s00595-020-02167-4

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  • DOI: https://doi.org/10.1007/s00595-020-02167-4

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