title: DeloRes trial: study protocol for a randomized trial comparing two standardized surgical approaches in rectal prolapse - Delorme's procedure versus resection rectopexy.
abstract: BACKGROUND
  More than 100 surgical approaches to treat rectal prolapse have been described. These can be done through the perineum or transabdominally. Delorme's procedure is the most frequently used perineal, resection rectopexy the most commonly used abdominal procedure. Recurrences seem more common after perineal compared to abdominal techniques, but the latter may carry a higher risk of peri- and postoperative morbidity and mortality.
  
  
  METHODS
  DeloRes is a randomized, controlled, observer-blinded multicenter trial with two parallel groups. Patients with a full-thickness rectal prolapse (third degree prolapse), considered eligible for both operative methods are included. The primary outcome is time to recurrence of full-thickness rectal prolapse during the 24 months following primary surgery. Secondary endpoints are time to and incidence of recurrence of full-thickness rectal prolapse during the 5-year follow-up, duration of surgery, morbidity, hospital stay, quality of life, constipation, and fecal incontinence. A meta-analysis was done on the basis of the available data on recurrence rates from 17 publications comprising 1,140 patients. Based on the results of a meta-analysis it is assumed that the recurrence rate after 2 years is 20% for Delorme's procedure and 5% for resection rectopexy. Considering a rate of lost to follow-up without recurrence of 30% a total of 130 patients (2 x 65 patients) was calculated as an adequate sample size to assure a power of 80% for the confirmatory analysis.
  
  
  CONCLUSIONS
  The DeloRes Trial will clarify which procedure results in a smaller recurrence rate but also give information on how morbidity and functional results compare.
  
  
  BACKGROUND
  German Clinical Trial Number DRKS00000482.
authors.affiliation: Department of Surgery, University Medical Centre Mannheim, University of Heidelberg, Heidelberg, Germany.
authors.forename: Simone
authors.initials: S
authors.lastname: Rothenhoefer
authors.forename: Florian
authors.initials: F
authors.lastname: Herrle
authors.forename: Alexander
authors.initials: A
authors.lastname: Herold
authors.forename: Andreas
authors.initials: A
authors.lastname: Joos
authors.forename: Dieter
authors.initials: D
authors.lastname: Bussen
authors.forename: Meinhard
authors.initials: M
authors.lastname: Kieser
authors.forename: Petra
authors.initials: P
authors.lastname: Schiller
authors.forename: Christina
authors.initials: C
authors.lastname: Klose
authors.forename: Christoph M
authors.initials: CM
authors.lastname: Seiler
authors.forename: Peter
authors.initials: P
authors.lastname: Kienle
authors.forename: Stefan
authors.initials: S
authors.lastname: Post
mesh_terms: D002985:Clinical Protocols; D013505:Digestive System Surgical Procedures / Q000379:methods*; D006801:Humans; D017063:Outcome Assessment, Health Care; D012005:Rectal Prolapse / Q000601:surgery*; D018401:Sample Size