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Related Concept Videos

Assessment of the Rectum and Anus01:25

Assessment of the Rectum and Anus

Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
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Related Experiment Video

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Delorme's Procedure for Full-Thickness Rectal Prolapse; Does it Alter Anorectal Function.

Sabry A Mahmoud1, Waleed Omar, Kamal Abdel-Elah

  • 1Colorectal Surgery Unit, Mansoura Faculty of Medicine, Elgomhoria St., Mansoura, Egypt.

The Indian Journal of Surgery
|October 2, 2013
PubMed
Summary

Delorme's procedure for rectal prolapse is effective, with 78.4% satisfactory outcomes. This surgical technique improved constipation and fecal incontinence, making it a preferred choice for elderly patients.

Keywords:
Anorectal dysfunctionDelorme’s operationRectal prolapse

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Area of Science:

  • Colorectal Surgery
  • Gastroenterology
  • Surgical Outcomes

Background:

  • Full-thickness rectal prolapse affects a significant patient population, often necessitating surgical intervention.
  • Traditional surgical approaches may carry risks, particularly for frail or elderly individuals.
  • Defecatory disorders, including constipation and fecal incontinence, are common comorbidities.

Purpose of the Study:

  • To evaluate the clinical and anorectal manometric outcomes of Delorme's procedure for full-thickness rectal prolapse.
  • To assess the efficacy of Delorme's procedure in patients with coexisting constipation and fecal incontinence.
  • To determine the safety and feasibility of Delorme's procedure as a treatment option.

Main Methods:

  • Retrospective analysis of 37 patients who underwent Delorme's procedure for full-thickness rectal prolapse.
  • Inclusion of patients with a mean age of 54.4 years and a mean follow-up of 27 months.
  • Assessment of operative time, blood loss, hospital stay, recurrence rates, and functional outcomes (constipation, incontinence).
  • Postoperative anorectal manometric studies (MRP, MSP, MTV, and UDV) were performed.

Main Results:

  • Satisfactory outcomes were reported in 78.4% of patients.
  • Prolapse recurrence occurred in six patients, with three successfully re-treated using the same technique.
  • Significant improvement in constipation symptoms was observed in 70% of constipated patients.
  • Seven of eleven (63.6%) preoperatively incontinent patients became fully continent postoperatively.
  • Anorectal manometry showed significant improvement in all patients with intact rectoanal inhibitory reflex (RAIR).

Conclusions:

  • Delorme's procedure offers satisfactory clinical and manometric results for full-thickness rectal prolapse.
  • The procedure demonstrates efficacy in improving associated defecatory disorders, including constipation and fecal incontinence.
  • Delorme's operation is a safe and effective alternative to abdominal procedures, particularly for elderly and frail patients.