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Internal Delorme's procedure for rectal outlet obstruction.

E Ganio1, S Martina, E Novelli

  • 1Colorectal Eporediensis Centre, Gruppo Policlinico di Monza, Divisione di Chirurgia Colorettale, Clinica Santa Rita, Vercelli, Italy. ganio.ezio@yahoo.it

Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland
|December 11, 2012
PubMed
Summary
This summary is machine-generated.

The internal Delorme's procedure (IDP) effectively treats obstructed defecation caused by rectal intussusception. This safe surgical option significantly improves constipation and patient satisfaction, with a low recurrence rate.

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Area of Science:

  • Colorectal Surgery
  • Gastroenterology
  • Pelvic Floor Disorders

Background:

  • Obstructed defecation syndrome (ODS) significantly impacts quality of life.
  • Rectal intussusception is a common cause of ODS.
  • Surgical interventions are often necessary for refractory ODS.

Purpose of the Study:

  • To evaluate the efficacy and safety of the internal Delorme's procedure (IDP) for ODS.
  • To assess functional outcomes and patient satisfaction following IDP.
  • To compare outcomes of IDP alone versus IDP with levatorplasty.

Main Methods:

  • A cohort of 167 patients with ODS and rectal intussusception underwent surgery between 2001 and 2009.
  • Patients were assessed using validated scores (CCIS, CCCS, ODS, PAC-QoL) pre- and post-operatively.
  • Follow-up averaged 3 years, with analysis of complications, continence, and functional improvement.

Main Results:

  • The internal Delorme's procedure (IDP) demonstrated significant improvements in constipation scores (CCCS and ODS) and reduced tenesmus.
  • Postoperative complications were low (10.2%), and 45.7% of previously incontinent patients regained normal continence.
  • Patient-reported outcomes, including quality of life and reduction in anxiety/depression, showed significant improvement (P < 0.001).

Conclusions:

  • The internal Delorme's procedure is an effective and safe surgical treatment for rectal outlet obstruction due to rectal intussusception.
  • IDP leads to excellent functional outcomes and high patient satisfaction.
  • The procedure offers a valuable option for patients suffering from complex obstructed defecation.