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Comparing perineal repairs for rectal prolapse: Delorme versus Altemeier



Data comparing surgical outcomes and quality of life (QOL) following perineal repair of rectal prolapse are limited. The aim of our study was to compare the short-term outcome and QOL of two perineal procedures in patients with rectal prolapse.


All patients with full-thickness rectal prolapse admitted to our institution and undergoing Delorme and Altemeier procedures from 2005 to 2013 were identified using an institutional, IRB-approved rectal prolapse database. Short-term outcomes and QOL were compared.


Seventy-five patients (93 % female) underwent rectal prolapse surgery: 22 Altemeier and 53 Delorme, mean age 72 ± 15 years. Sixty-six percentage of patients were ASA grade III or IV (Table 1). The median hospital stay was longer in Altemeier’s group [4 (1–44) days vs. 3 (0–14) days; p = 0.01]. After a median follow-up of 13 (1–88) months, the rate of recurrent prolapse was 14 % (n = 11) [Altemeier 2 (9 %) vs. Delorme 9 (16 %) p = 0.071]. Postoperative complication rate was 12 % (n = 9) [Altemeier 5 (22 %) vs. Delorme 4 (7 %), p = 0.04]. There was no mortality. The Cleveland Global Quality of Life scores in each group were 0.6 ± 0.2 and 0.5 ± 0.3, respectively (p = 0.59), and were not changed by the surgery.

Table 1 Patient’s characteristics and procedures outcomes


In patients where abdominal repair of rectal prolapse is judged to be unwise, a Delorme procedure offers short-term control of the prolapse with low risk of complications and with reasonable function. In addition, patients that recur after a Delorme procedure can undergo another similar transanal procedure without compromising the vascular supply of the rectum.

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Fig. 1


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Poster presentation at the annual meeting of the American Society of Colon and Rectal Surgeons, Hollywood, Florida, May 17–21, 2014.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with ethical standards of, Cleveland Clinic Foundation, Cleveland, Ohio, USA.

Informed consent

A waiver of consent was obtained from the Institutional Review Board.

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Correspondence to G. Ozuner.

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Elagili, F., Gurland, B., Liu, X. et al. Comparing perineal repairs for rectal prolapse: Delorme versus Altemeier. Tech Coloproctol 19, 521–525 (2015).

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  • Rectal prolapse
  • Delorme
  • Altemeier
  • Perineal repair