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Recurrence after Delorme's procedure in a single and multi-surgeon setting
J Plaskett1, R Baigrie1, S R Thomson1
1Department of Surgery, Groote Schuur Hospital, University of Cape Town, South Africa.
Summary
Delorme's procedure for full-thickness rectal prolapse has a 23% recurrence rate. Outcomes were similar regardless of surgeon experience, making it a viable option for elderly patients.
Area of Science:
- Colorectal Surgery
- Gastroenterology
- Surgical Outcomes
Background:
- Delorme's procedure (DP) is a perineal repair for full-thickness rectal prolapse (FTRP).
- It is favored in elderly/comorbid patients due to low perioperative morbidity.
- DP recurrence rates are reportedly higher than abdominal approaches.
Purpose of the Study:
- To report long-term clinical outcomes of recurrence after DP.
- To evaluate postoperative bowel function following DP.
- To compare outcomes between single-surgeon and multi-surgeon cohorts.
Main Methods:
- Retrospective cohort study of 70 FTRP patients undergoing DP (2001-2014).
- Primary outcome: absence of FTRP recurrence.
- Secondary outcomes: 30-day mortality/morbidity, bowel function, hospital stay.
Main Results:
- 16 recurrences (23%) observed over median 46-month follow-up.
- No significant difference in recurrence rates or time to recurrence between single- and multi-surgeon cohorts.
- 30-day mortality was 4.3%; 6 minor and 6 major complications occurred.
Conclusions:
- DP demonstrates a 23% long-term recurrence rate for FTRP.
- Outcomes are comparable between experienced colorectal specialists and supervised trainees.
- DP remains a viable surgical option for select FTRP patients.
