Delorme's transrectal excision for internal rectal prolapse. Patient selection, technique, and three-year follow-up

Area of Science:

• Colorectal Surgery
• Gastroenterology
• Surgical Outcomes

Background:

• Functional outlet obstruction and internal rectal intussusception are common causes of refractory constipation.
• Abdominal surgical approaches may have significant physiologic impact and often fail to relieve constipation.
• Transrectal procedures offer a less invasive alternative for managing these conditions.

Purpose of the Study:

• To evaluate the long-term efficacy of Delorme's transrectal excision for internal rectal intussusception.
• To assess sustained symptomatic relief in patients with refractory constipation.
• To identify critical technical elements and potential complications of the procedure.

Main Methods:

• Retrospective analysis of patients undergoing Delorme's transrectal excision for internal rectal intussusception.
• Assessment of sustained symptomatic relief at a minimum three-year postoperative follow-up.
• Review of surgical technique, pitfalls, and complications.

Main Results:

• Delorme's transrectal excision achieved sustained symptomatic relief in over 70% of patients.
• The procedure demonstrated long-term efficacy in managing refractory constipation associated with internal rectal intussusception.
• The study identified key technical aspects and potential complications.

Conclusions:

• Delorme's transrectal excision is an effective surgical therapy for functional outlet obstruction due to internal rectal intussusception.
• The procedure offers sustained relief for refractory constipation, underscoring the importance of selecting patients based on both anatomic and functional evaluations.
• Understanding surgical nuances is crucial for successful outcomes.