Comparing perineal repairs for rectal prolapse: Delorme versus Altemeier
Purpose 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 shortterm outcome and QOL of two perineal procedures in patients with rectal prolapse. Methods All patients with full-thickness rec...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Springer
2015
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| Subjects: | |
| Online Access: | http://irep.iium.edu.my/69627/ http://irep.iium.edu.my/69627/ http://irep.iium.edu.my/69627/ http://irep.iium.edu.my/69627/1/elagili2015.pdf |
| Summary: | Purpose 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 shortterm outcome and QOL of two perineal procedures in
patients with rectal prolapse.
Methods 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.
Results 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.
Conclusions 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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