Comparative study between Delorme operation with or without postanal repair and levateroplasty in treatment of complete rectal prolapse

INTERNATIONAL JOURNAL OF SURGERY

卷:11

Article

Youssef, Mohamed¹  Thabet, Waleed¹  El Nakeeb, Ayman¹  Magdy, Alaa¹  Abd Alla, Emad¹  Abd El Nabeey, Mahmoud¹  Fouda, El Yamani¹  Omar, Waleed¹  Farid, Mohamed¹ 

[1] Mansoura Univ Hosp, Dept Gen Surg, Colorectal Surg Unit, Mansoura, Egypt

关键词: Rectal prolapse;    Anal manometery;    Levator ani;    Delorme;   

DOI  :  10.1016/j.ijsu.2012.11.011

来源: Elsevier

【 摘 要 】

Background: Rectal prolapse is a distressing and socially disabling condition. controversy exists regarding the preferred surgical technique for the treatment of complete rectal prolapse. Objective: We compared Delorme operation alone or with postanal repair and levatroplasty in treating complete rectal prolapse. Methods: Consecutive patients treated for rectal prolapse at our colorectal unit were evaluated for inclusion. Participants were randomly allocated to receive Delorme operation only (GI), or Delorme operation with postanal repair and levatorplasty (GII). Main outcome measures: The primary outcome measure was recurrence rate; secondary outcomes included improvement of constipation, incontinence, operative time, anal manometery and postoperative complications. Results: Eighty-two consecutive patients with rectal prolapse were randomized. There was a significant difference between the two groups with longer operative time in group II. Recurrence rate after one year was (14.28% in GI, and 2.43% in GII, respectively (P = 0.043). Constipation improved in group I & II but there was a significant difference in constipation scores postoperatively between the two groups. There was improvement in continence mechanism in both groups postoperatively but being higher in group II and this produce a significant statistical difference (0.004). Mean satisfaction score was significantly higher in group II than group I. Both groups succeed to produce a significant change in resting and squeeze pressure before & after the operation. Conclusions: Delorme operation seems to be an effective procedure for treating complete rectal prolapse especially if combined with postanal repair and levatorplasty. Clinical trial registration: NCT01656369. (C) 2012 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

【 授权许可】

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