title: Evaluation of Clinical Outcomes after Abdominal Rectopexy and Delorme's Procedure for Rectal Prolapse: A Prospective Study.
abstract: BACKGROUND
  Complete rectal prolapse is characterized by protrusion of full thickness rectal wall through the anal orifice. Despite its rarity more than 100 surgical procedures have been described and there are no good evidence based recommendations for selection of a surgical procedure. This study was conducted to evaluate the clinical outcomes of commonly used procedures for rectal prolapse at our hospital.
  
  
  METHODS
  Twenty seven patients presenting with complete rectal prolapse between May 2011 to May 2013 were included in this prospective study. Patients underwent either Abdominal rectopexy or Delorme's procedure after evaluation, based on clinical judgment of experienced surgeons. Patient characteristics, complications, post-operative length of hospitalization and clinical outcomes were assessed. Patients were followed up for a mean duration of 14 months.
  
  
  RESULTS
  Seventeen patients underwent Abdominal rectopexy (Posterior mesh rectopexy), ten patients underwent Delorme's procedure. No postoperative mortalities or major complications were noted. Post operative morbidity (minor) was 17% in Abdominal rectopexy group and 10% in Delormes group 0%. Incontinence improved in all six patients (100%) in rectopexy group, four patients (80%) in Delorme's procedure group. Two patients (11%) in rectopexy group reported increase in constipation post operatively. There was one recurrence in Delorme's procedure group with no recurrences in Abdominal rectopexy group.
  
  
  CONCLUSIONS
  The treatment of rectal prolapse should be individualized to achieve best results. Abdominal rectopexy can be safely applied in most of patients with minimal post operative increase in constipation and recurrence by using posterior mesh rectopexy technique. Delorme's procedure can be performed with minimal morbidity and shorter hospital stay and good functional results with acceptable recurrence rate. Delorme's can be considered as an alternative to rectopexy not only in patients unfit for laparotomy but also in individuals with a short prolpase, avoiding a laparotomy.
authors.affiliation: Junior Resident, Department of General Surgery, Shreyas , Pragathi Coloney, Near Baliga Stores, Bejai, Managalore, India .
authors.forename: Hemanth
authors.initials: H
authors.lastname: Makineni
authors.affiliation: Associate Professor, Department of General Surgery, Shreyas , Pragathi Coloney, Near Baliga Stores, Bejai, Managalore, India .
authors.forename: Poornachandra
authors.initials: P
authors.lastname: Thejeswi
authors.affiliation: Professor, Department of General Surgery, Shreyas , Pragathi Coloney, Near Baliga Stores, Bejai, Managalore, India .
authors.forename: B K Shivprasad
authors.initials: BK
authors.lastname: Rai
keywords: Delorme’s procedure; Rectal prolapse; Rectopexy