Posterior Sagittal Mesh Rectopexy versus Delorme's Procedure in The Treatment of Complete Rectal Prolapse in Adult | ||
| The Egyptian Journal of Hospital Medicine | ||
| Article 27, Volume 97, Issue 1, October 2024, Pages 3606-3610 PDF (467.45 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejhm.2024.385641 | ||
| Abstract | ||
| Background: Although both transabdominal and perineal approaches have been suggested for correcting rectal prolapse, the optimal procedure for this condition is still up for debate. Objective: This study aimedto evaluate Delorme's method for treating full rectal prolapse in adults and compare it prospectively with posterior sagittal mesh rectopexy. Patients and methods: Two groups of twenty-two patients were randomly assigned to have different treatments for total rectal prolapse. Eleven patients in group I got Delorme's surgery (DP), while eleven patients in group II underwent posterior sagittal mesh rectopexy (PSMR). A comprehensive patient history was taken, a detailed physical examination was performed, and a digital evaluation of the sphincter tone was performed as part of the meticulous preoperative evaluation. Ultrasound and electromyography were used to assess patients with fecal incontinence. Results: Constipation affected 681% of patients, incontinence to flatus 27.2%, loose stool 13.6%, and solid stool 9%. Mass bulging through the anus on straining was the most prevalent symptom. Group II (PSMR) had an average operating time of 80 minutes, while group I (DP) had an average operating time of 106 minutes with a considerable difference. Up to twelve months of follow-up was scheduled. In group 1(DP), 2 patients (18.2%) experienced a complete recurrence, while in group 1I (PSMR) 2 patients (18.2%) experienced a partial recurrence. Postoperative constipation was experienced by one patient (9.1% of group I) and two patients (18.2% of group II). Within two to four months after surgery, the patients who had anal incontinence due to flatus or loose stool before the procedure regained continence, except for two patients who had incontinence due to solid stool, who did not recover continence at all. Conclusions: Patients with complete rectal prolapse may benefit from the posterior sagittal approach, which has a short operating time, a good functional outcome, and a largely partial recurrence rate. | ||
| Keywords | ||
| Posterior sagittal mesh rectopexy; Delorme’s procedure; Rectal prolapse | ||
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