Comparing perineal repairs for rectal prolapse: Delorme versus Altemeier

Area of Science:

• Colorectal surgery
• Surgical outcomes research
• Quality of life assessment

Background:

• Rectal prolapse repair via perineal approach lacks comparative outcome data.
• Quality of life (QOL) is a critical endpoint in surgical decision-making for rectal prolapse.

Purpose of the Study:

• To compare short-term surgical outcomes and QOL between the Delorme and Altemeier procedures for rectal prolapse.
• To evaluate complication rates and recurrence following two distinct perineal repair techniques.

Main Methods:

• Retrospective analysis of patients undergoing Delorme or Altemeier procedures for full-thickness rectal prolapse (2005-2013).
• Comparison of short-term outcomes including hospital stay, complication rates, and prolapse recurrence.
• Assessment of Quality of Life using Cleveland Global Quality of Life scores.

Main Results:

• The Delorme procedure was associated with a significantly lower postoperative complication rate (7% vs. 22%) compared to the Altemeier procedure.
• Hospital stay was longer in the Altemeier group (median 4 days vs. 3 days, p=0.01).
• Recurrence rates (16% Delorme vs. 9% Altemeier) and QOL scores were not significantly different between the groups.

Conclusions:

• The Delorme procedure provides effective short-term rectal prolapse control with a lower complication risk, making it a viable option when abdominal surgery is contraindicated.
• Transanal re-operation after a failed Delorme procedure is feasible without compromising rectal vascularity.
• Neither procedure significantly altered postoperative Quality of Life scores in this cohort.