The Midwest Surgical AssociationThe Delorme repair for full-thickness rectal prolapse: a retrospective review
Section snippets
Patients and Methods
A retrospective chart review of 76 consecutive patients who underwent the Delorme repair between March of 1994 and June of 2006 was performed. Patients without full-thickness rectal wall prolapse were excluded. Patients were not excluded if they came to Delorme after a previously failed procedure for prolapse. Preoperative symptoms including bleeding, incontinence, and constipation were obtained from the patient chart. Preoperative history of chronic obstructive pulmonary disease,
Results
A total of 76 patients underwent the Delorme procedure for full-thickness rectal prolapse during the period described. Seventy patients underwent a primary prolapse procedure and 6 had Delorme as a secondary procedure after a prior failed prolapse procedure. The median age of the patients was 74 years (range, 16–93 y). Thirteen patients (17%) were younger than the age of 50. Only 5 of the patients were male. Follow-up data were available for all 76 patients.
Postoperative data were available for
Comments
This series of patients represents our experience using the Delorme procedure for the repair of full-thickness rectal prolapse. This series differs from many others by specifically reporting and emphasizing outcomes in younger, medically fit patients. Many previous investigators have reported young patients undergoing Delorme procedure.1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 Even the eponymous Edmund Delorme's first case report was of a 22-year-old patient.
Many investigators have suggested that
Conclusion
The Delorme procedure's utility in older, less fit patients is reinforced. No statistically significant predictors of complication, readmission, or recurrence were identified in either the cohort at large or in the younger age subset. There is a trend towards more frequent recurrence early in a surgeon's learning curve. The Delorme group in general has outcomes comparable with historical Altemeier procedure outcomes without the risk of a full-thickness anastomosis. The recurrence rate in
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