Annals of Coloproctology

Original Articles

Benign proctology,Complication,Biomarker & risk factor

Longer prolapsed rectum length increases recurrence risk after Delorme’s procedure: Taro Tanabe, Emi Yamaguchi, Takuya Nakada, Risa Nishio, Kinya Okamoto, Tetsuo Yamana; Ann Coloproctol. 2022;38(4):314-318. Published online July 13, 2021; DOI: https://doi.org/10.3393/ac.2020.01032.0147

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Purpose
Risk factors for recurrence of rectal prolapse after surgery remain unclear. Delorme’s procedure is often selected for relatively small-sized rectal prolapse, but there are few reports discussing the association between prolapsed rectum length and prolapse recurrence after Delorme’s procedure. We hypothesized that patients with longer rectal prolapses are at a higher risk of recurrence after Delorme’s procedure.
Methods
The study population comprised patients with rectal prolapse who underwent Delorme’s procedure between January 2014 and December 2019 at Tokyo Yamate Medical Center. We extracted data on patient age, sex, body mass index, previous history of anal surgery, previous history of surgery for rectal prolapse, and length of prolapse, to identify risk factors for prolapse recurrence.
Results
Altogether, 96 patients were eligible for analysis. The median length of the prolapsed rectum was 3.0 cm (range, 1.0–6.6 cm). Twenty-four patients (25.0%) experienced recurrence after Delorme’s procedure after a median of 7.5 months (interquartile range, 3.2–20.9 months). Multivariate analysis revealed that longer prolapsed rectum length increased the risk of recurrence after Delorme’s procedure (hazard ratio, 6.28; 95% confidence interval, 1.83–21.50; P<0.001).
Conclusion
The length of the prolapsed rectum should be measured before Delorme’s procedure for rectal prolapse, because length is associated with a risk of recurrence after the surgery.

Citations

Citations to this article as recorded by

Surgical approaches for complete rectal prolapse
Long Wu, Huan Wu, Song Mu, Xiao-Yun Li, Yun-Huan Zhen, Hai-Yang Li
World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef
Tratamiento quirúrgico del prolapso rectal completo del adulto
C. Korkmaz, G. Meurette
EMC - Técnicas Quirúrgicas - Aparato Digestivo.2024; 40(1): 1. CrossRef
Trattamento chirurgico del prolasso rettale completo dell’adulto
C. Korkmaz, G. Meurette
EMC - Tecniche Chirurgiche Addominale.2024; 30(1): 1. CrossRef
The Predictive Risk Factor of Postoperative Recurrence Following Altemeier's and Delorme's Procedures for Full-thickness Rectal Prolapse: An Analysis of 127 Japanese Patients in a Single Institution
Yasuyuki Miura, Kimihiko Funahashi, Akiharu Kurihara, Satoru Kagami, Takayuki Suzuki, Kimihiko Yoshida, Mitsunori Ushigome, Tomoaki Kaneko
Journal of the Anus, Rectum and Colon.2024; 8(3): 171. CrossRef
Modified Altemeier Procedure as Management for Incarcerated Rectal Prolapse in a Young Healthy Male Patient: A Case Report and Literature Review
Leenah Abdulgader, Ebtesam Al-Najjar, Bayan Khasawneh, Abdullah Esmail
Medicina.2024; 60(11): 1872. CrossRef
Traitement chirurgical du prolapsus rectal complet de l’adulte
C. Korkmaz, G. Meurette
EMC - Techniques chirurgicales - Appareil digestif.2023; 40(4): 1. CrossRef

Comparison of Delorme-Thiersch Operation Outcomes in Men and Women With Rectal Prolapse: Keehoon Hyun, Seo-Gue Yoon; Ann Coloproctol. 2019;35(5):262-267. Published online October 31, 2019; DOI: https://doi.org/10.3393/ac.2018.10.15.1

4,128 View
85 Download
4 Web of Science
5 Citations

Abstract PDF

Purpose
The laparoscopic rectopexy has become increasingly popular with verified stability, surgical route selection should be tailored to individual patient characteristics rather than operative risk. The perineal approach is useful in young male patients who need to preserve fertility. This study aimed to compare the characteristics of men and women who underwent Delorme-Thiersch procedures and analyze the postoperative outcomes of the perineal approach by sex.
Methods
We retrospectively reviewed the medical records of 293 patients who underwent Delorme-Thiersch operations in Seoul Song Do Colorectal Hospital between January 2011 and September 2017. Patient clinical characteristics and postoperative complications were analyzed by sex. We analyzed surgical outcomes with preoperative and 3-month postoperative incontinence questionnaires, constipation levels, and anal manometry.
Results
In this study, men with rectal prolapse were younger than women with the same condition. American Society of Anesthesiologists physical status classifications were higher in women and women had more L-spine X-ray and pudendal nerve terminal motor latency test abnormalities. Anorectal manometry pressures were higher in men. Men also had longer operation times and hospital stays and more postoperative complications (8 T ring infections, 6 patients with bleeding, 3 with strictures, 2 with severe pain, and 2 with rectal perforations). The recurrence rate was higher among women.
Conclusion
Men with rectal prolapse were younger, healthier, and had relatively better anorectal function than women. The Delorme-Thiersch operation in men promoted lower recurrence rates and was advantageous in preserving the fertility of young patients, but the incidence of complications was also higher in men. Adequate counseling and preparation for the possibility of complications are needed.

Citations

Citations to this article as recorded by

Assessment of Laparoscopic Posterior Mesh Rectopexy for Complete Rectal Prolapse: A Case Series with Review of Literature
Vishal Chawda, Abhijit Joshi
International Journal of Recent Surgical and Medical Sciences.2023; 09(01): 059. CrossRef
A comparative study on the surgical options for male rectal prolapse
Han Deok Kwak, Jun Seong Chung, Jae Kyun Ju
Journal of Minimal Access Surgery.2022; 18(3): 426. CrossRef
Clinical outcomes of surgical management for recurrent rectal prolapse: a multicenter retrospective study
Kwang Dae Hong, Keehoon Hyun, Jun Won Um, Seo-Gue Yoon, Do Yeon Hwang, Jaewon Shin, Dooseok Lee, Se-Jin Baek, Sanghee Kang, Byung Wook Min, Kyu Joo Park, Seung-Bum Ryoo, Heung-Kwon Oh, Min Hyun Kim, Choon Sik Chung, Yong Geul Joh
Annals of Surgical Treatment and Research.2022; 102(4): 234. CrossRef
Longer prolapsed rectum length increases recurrence risk after Delorme’s procedure
Taro Tanabe, Emi Yamaguchi, Takuya Nakada, Risa Nishio, Kinya Okamoto, Tetsuo Yamana
Annals of Coloproctology.2022; 38(4): 314. CrossRef
Perineal stapled prolapse resection in combination with Thiersch operation for relapsed rectal prolapse: a case report
Teppei Kamada, Hironori Ohdaira, Junji Takahashi, Yoshinobu Fuse, Wataru Kai, Keigo Nakashima, Yuichi Nakaseko, Norihiko Suzuki, Masashi Yoshida, Takeo Usui, Yutaka Suzuki
Surgical Case Reports.2021;[Epub] CrossRef

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