Abstract
PURPOSE: This study was designed to assess the results of a minimally invasive surgical procedure for the correction of complete rectal prolapse in a poor surgical risk group. METHODS: Over a ten-year period, 40 patients underwent 41 Delorme operations when advanced age and/or poor overall health mitigated against an abdominal approach. Mean age was 82 (range, 30–100) years. Eighty-eight percent were females. Surgery was performed in the prone jackknife position utilizing intravenous sedation and local anesthesia. RESULTS: Follow-up ranges from 1 year to 2 years (mean, 47 months). There have been 9 recurrences in 8 patients (22 percent). Mean time to recurrence was 13 months (range, 1 month to 6 years). One death occurred in an 81-year-old patient within 24 hours of surgery from cardiopulmonary arrest. Minor complications occurred in 25 percent of patients. CONCLUSION: Satisfactory prolapse repair was safely performed in 78 percent of this high-risk group. Pitfalls in performing this procedure relate primarily to associated perineal and colonic conditions. Most prominent among these conditions are weak or absent anal sphincter tone, perineal descent, and previous sphincter injury. Extensive diverticular disease may prohibit effective and complete proximal mucosectomy. An inadequate mucosectomy sets the stage for early recurrence of prolapse.
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References
Boutsis C, Ellis H. The Ivalon-sponge-wrap operation for rectal prolapse: an experience with 26 patients, Dis Colon Rectum 1974;17:21–37.
Delorme R, Sur le traitement des prolapsus du rectum totaux par l'excision de la muquese rectale au rectal-colique. Bull Mem Soc Chir Paris 1900;26:499–518.
Moskalenko VW. Modifications of Delorme's resection of rectal mucosa for prolapse of the rectum. Int Surg 1973;58:192–4.
Uhlig BE, Sullivan ES. The modified Delorme operation: its place in surgical treatment for massive rectal prolapse. Dis Colon Rectum 1979;22:513–21.
Nay HR, Blair CR. Perineal surgical repair of rectal prolapse. Am J Surg 1972;123:577–9.
Christiansen J, Kirkegaard P. Delorme's operation for complete rectal prolapse. Br J Surg 1981;68:537–8.
Beahrs OH, Theuerkauf FJ, Hill JR. Procidentia: surgical treatment. Dis Colon Rectum 1972;15:337–46.
Gundersen AL, Cogbill TH, Landercasper J. Reappraisal of Delorme's procedure for rectal prolapse. Dis Colon Rectum 1985;28:721–4.
Monson JR, Jones NA, Vowden P, Brennan TG. Delorme's operation: the first choice incomplete rectal prolapse? Ann R Coll Surg Engl 1986;68:43–6.
Sullivan ES, Leaverton GH, Hardwick CE. Transrectal perineal repair: an adjunct to improved function after anorectal surgery. Dis Colon Rectum 1968;11:106–14.
Prasad ML, Pearl RK, Abcarian H, Orsay CP, Nelson RL. Perineal proctectomy, posterior rectopexy, and postanal levator repair for the treatment of rectal prolapse. Dis Colon Rectum 1986;29:547–52.
Graf W, Ejerblad S, Krog M, Pahlman L, Gerdin B. Delorme's operation for rectal prolapse in elderly or unfit patients. Eur J Surg 1992;158:555–7.
Gordon PH, Hoexter B. Complications of the Ripstein procedure. Dis Colon Rectum 1978;21:277–80.
Launer DP, Fazio VW, Weakley FL, Turnbull RB, Jagelman DG, Lavery IC. The Ripstein procedure: a 16-year experience. Dis Colon Rectum 1982;25:41–5.
Williams JG. Perineal approaches to repair of rectal prolapse. Semin Colon Rectal Surg 1991;2:198–204.
Abulafi AM, Sherman IW, Fiddian RV, Rothwell-Jackson RL. Delorme operation for rectal prolapse. Ann R Coll Surg Engl 1990;72:382–5.
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Oliver, G.C., Vachon, D., Eisenstat, T.E. et al. Delorme's procedure for complete rectal prolapse in severely debilitated patients. Dis Colon Rectum 37, 461–467 (1994). https://doi.org/10.1007/BF02076192
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DOI: https://doi.org/10.1007/BF02076192