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...

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Main Authors:	Faisal, Elagili, Gurland, Brooke H., Liu, Xiaobo, Church, James Michael, Ozuner, Gokhan
Format:	Article
Language:	English
Published:	Springer 2015
Subjects:	RD Surgery
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

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recordtype	eprints
spelling	iium-696272019-04-03T06:29:59Z http://irep.iium.edu.my/69627/ Comparing perineal repairs for rectal prolapse: Delorme versus Altemeier Faisal, Elagili Gurland, Brooke H. Liu, Xiaobo Church, James Michael Ozuner, Gokhan RD Surgery 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. Springer 2015-09 Article PeerReviewed application/pdf en http://irep.iium.edu.my/69627/1/elagili2015.pdf Faisal, Elagili and Gurland, Brooke H. and Liu, Xiaobo and Church, James Michael and Ozuner, Gokhan (2015) Comparing perineal repairs for rectal prolapse: Delorme versus Altemeier. Techniques in Coloproctology, 19 (9). pp. 521-525. ISSN 1123-6337 E-ISSN 1128-045X https://link.springer.com/article/10.1007/s10151-015-1337-y 10.1007/s10151-015-1337-y
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English
topic	RD Surgery
spellingShingle	RD Surgery Faisal, Elagili Gurland, Brooke H. Liu, Xiaobo Church, James Michael Ozuner, Gokhan Comparing perineal repairs for rectal prolapse: Delorme versus Altemeier
description	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.
format	Article
author	Faisal, Elagili Gurland, Brooke H. Liu, Xiaobo Church, James Michael Ozuner, Gokhan
author_facet	Faisal, Elagili Gurland, Brooke H. Liu, Xiaobo Church, James Michael Ozuner, Gokhan
author_sort	Faisal, Elagili
title	Comparing perineal repairs for rectal prolapse: Delorme versus Altemeier
title_short	Comparing perineal repairs for rectal prolapse: Delorme versus Altemeier
title_full	Comparing perineal repairs for rectal prolapse: Delorme versus Altemeier
title_fullStr	Comparing perineal repairs for rectal prolapse: Delorme versus Altemeier
title_full_unstemmed	Comparing perineal repairs for rectal prolapse: Delorme versus Altemeier
title_sort	comparing perineal repairs for rectal prolapse: delorme versus altemeier
publisher	Springer
publishDate	2015
url	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
first_indexed	2023-09-18T21:38:49Z
last_indexed	2023-09-18T21:38:49Z
_version_	1777413002241245184

Comparing perineal repairs for rectal prolapse: Delorme versus Altemeier

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