Complete rectal prolapse clinical and functional outcome with Delorme's procedure.
BACKGROUND
Many surgical techniques -both through the perineal and abdominal routes- have been described for the treatment of rectal prolapse. The aim of this work is to evaluate the clinical and functional outcome with Delorme's perineal procedure.


METHODS
Twenty-one patients with complete rectal prolapse were studied from July 2000 to October 2005. Age, gender, anesthetic risk, and accompanying symptoms were all assessed. Diagnostic tests performed included: colonoscopy, anorectal manometry before and after surgery, and 360 masculine endoanal ultrasonography. Delorme's procedures were carried out by only one surgical team.


RESULTS
No mortality occurred, and morbidity was minimal. Prolapse relapse rate was 9.52% with a mean follow-up of 34 months. Anal continence improved in 87.5% of patients, and no surgery-associated constipation ensued. Mean hospital stay was 2 (range 1-4) days. During the postoperative period no pain developed in 17 patients, and 4 patients had mild pain. Satisfaction with surgery was high in 16 cases (76.19%), moderate in 3 (14.28%), and low in 2 (9.52%).


CONCLUSIONS
Delorme's procedure for the management of complete rectal prolapse is associated with low morbidity, improves anal continence, gives rise to no postsurgical constipation, and has an acceptable relapse rate. Patient satisfaction with this procedure is high because of its high comfortability (intradural anesthesia, short hospital stay, and little postoperative pain) and optimal results.
Pascual Montero
J A
JA
Service of Gastrointestinal Surgery, Hospital 12 de Octubre, Madrid, Spain. pepasmon@hotmail.com
Martínez Puente
M C
MC
Pascual
I
I
Butrón Vila
T
T
García Borda
F J
FJ
Lomas Espadas
M
M
Hidalgo Pascual
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy; D013505:Digestive System Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011183:Postoperative Complications; D012005:Rectal Prolapse / Q000503:physiopathology / Q000601:surgery*; D012007:Rectum / Q000503:physiopathology / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome