Skip to main content
Top
Published in: International Journal of Colorectal Disease 5/2010

01-05-2010 | Original Article

A modified Delorme’s operation for the treatment of rectal mucosal prolapse

Authors: Yonggang Wang, Chunbao Zhai, Liyun Niu, Lijun Tian, Jianyong Yang, Zheng Hu

Published in: International Journal of Colorectal Disease | Issue 5/2010

Login to get access

Abstract

Aims

Many procedures have been described for the treatment of rectal internal mucosal prolapse (RMP), but the therapeutic effect is questionable. This work is to evaluate clinical and functional outcome of a modified Delorme’s operation—trans-anal purse-string sutures for rectal mucosa and submucosa (TAS) for the treatment of RMP.

Methods

The clinical data of 58 patients with rectal mucosal prolapse treated with rectal mucosa and submucosal tissue (TAS) between June 2004 and June 2008 were analyzed retrospectively.

Results

No patient died. Satisfaction with surgery was high in 48 cases (82.8%), moderate in seven (12.1%), and low in three (5.17%). Prolapse relapse rate was 5.17%. Anal tenesmus and urge to defecate resolved in 52 (89.7%) patients. Constipation improved in 25 of 28 (89.3%) previously constipated patients. No surgery-associated constipation occurred. The mean operative time was 31 (range 22–46) min. Mean hospital stay was 3 days (range 2–6). Mean patient follow-up was 32 months (range 12–60).

Conclusions

From our data, TAS for the treatment of RMP showed encouraging results with little complications and an acceptable relapse rate. This economical procedure induces only mild trauma and is easy to perform, making it worthy of further practice and investigation.
Literature
1.
go back to reference Sitzler PJ, Kamm MA, Nicholls RJ et al (1998) Long-term clinical outcome of surgery for solitary rectal ulcer syndrome. Br J Surg 85:1246–1250CrossRefPubMed Sitzler PJ, Kamm MA, Nicholls RJ et al (1998) Long-term clinical outcome of surgery for solitary rectal ulcer syndrome. Br J Surg 85:1246–1250CrossRefPubMed
2.
go back to reference Berman IR, Harris MS, Rabeler MB (1990) Delorme’s transrectal excision for internal rectal prolapse: patient selection, technique, and three-year follow-up. Dis Colon Rectum 33:573–580CrossRefPubMed Berman IR, Harris MS, Rabeler MB (1990) Delorme’s transrectal excision for internal rectal prolapse: patient selection, technique, and three-year follow-up. Dis Colon Rectum 33:573–580CrossRefPubMed
3.
go back to reference Pescatori M, Quondamcarlo C (1999) A new grading of rectal internal mucosal prolapse and its correlation with diagnosis and treatment. Int J Colorectal Dis 14:245–249CrossRefPubMed Pescatori M, Quondamcarlo C (1999) A new grading of rectal internal mucosal prolapse and its correlation with diagnosis and treatment. Int J Colorectal Dis 14:245–249CrossRefPubMed
4.
go back to reference Pescatori M, Boffi F, Russo A et al (2006) Complications and recurrence after excision of rectal internal mucosal prolapse for obstructed defaecation. Int J Colorectal Dis 21:160–165CrossRefPubMed Pescatori M, Boffi F, Russo A et al (2006) Complications and recurrence after excision of rectal internal mucosal prolapse for obstructed defaecation. Int J Colorectal Dis 21:160–165CrossRefPubMed
5.
go back to reference van Tets WF, Kuijpers JH (1995) Internal rectal intussusception—fact or fancy? Dis Colon Rectum 38:1080–1083CrossRefPubMed van Tets WF, Kuijpers JH (1995) Internal rectal intussusception—fact or fancy? Dis Colon Rectum 38:1080–1083CrossRefPubMed
6.
7.
go back to reference Johnson E, Carlsen E, Mjåland O et al (2003) Resection rectopexy for internal rectal intussusception reduces constipation and incomplete evacuation of stool. Eur J Surg Suppl 588:51–56PubMed Johnson E, Carlsen E, Mjåland O et al (2003) Resection rectopexy for internal rectal intussusception reduces constipation and incomplete evacuation of stool. Eur J Surg Suppl 588:51–56PubMed
8.
go back to reference Marchal F, Bresler L, Brunaud L et al (2001) Solitary rectal ulcer syndrome: a series of 13 patients operated with a mean follow-up of 4.5 years. Int J Colorectal Dis 16:228–233CrossRefPubMed Marchal F, Bresler L, Brunaud L et al (2001) Solitary rectal ulcer syndrome: a series of 13 patients operated with a mean follow-up of 4.5 years. Int J Colorectal Dis 16:228–233CrossRefPubMed
9.
go back to reference Tsiaoussis J, Chrysos E, Athanasakis E et al (2005) Rectoanal intussusception: presentation of the disorder and late results of resection rectopexy. Dis Colon Rectum 48:838–844CrossRefPubMed Tsiaoussis J, Chrysos E, Athanasakis E et al (2005) Rectoanal intussusception: presentation of the disorder and late results of resection rectopexy. Dis Colon Rectum 48:838–844CrossRefPubMed
10.
go back to reference Pescatori M (2009) Long-term follow-up of simultaneous abdominoperineal repair of enterorectocele and internal mucosal prolapse. Dis Colon Rectum 52:327–335PubMed Pescatori M (2009) Long-term follow-up of simultaneous abdominoperineal repair of enterorectocele and internal mucosal prolapse. Dis Colon Rectum 52:327–335PubMed
11.
go back to reference Jayne DG, Schwandner O, Stuto A (2009) Stapled transanal rectal resection for obstructed defecation syndrome: one-year results of the European STARR Registry. Dis Colon Rectum 52:1205–1212PubMed Jayne DG, Schwandner O, Stuto A (2009) Stapled transanal rectal resection for obstructed defecation syndrome: one-year results of the European STARR Registry. Dis Colon Rectum 52:1205–1212PubMed
12.
go back to reference Boccasanta P, Venturi M, Calabro G et al (2008) Stapled transanal rectal resection in solitary rectal ulcer associated with prolapse of the rectum: a prospective study. Dis Colon Rectum 51:348–354CrossRefPubMed Boccasanta P, Venturi M, Calabro G et al (2008) Stapled transanal rectal resection in solitary rectal ulcer associated with prolapse of the rectum: a prospective study. Dis Colon Rectum 51:348–354CrossRefPubMed
13.
go back to reference Dodi G, Pietroletti R, Milito G et al (2003) Bleeding, incontinence, pain and constipation after STARR transanal double stapling rectotomy for obstructed defecation. Tech Coloproctol 7:148–153CrossRefPubMed Dodi G, Pietroletti R, Milito G et al (2003) Bleeding, incontinence, pain and constipation after STARR transanal double stapling rectotomy for obstructed defecation. Tech Coloproctol 7:148–153CrossRefPubMed
14.
go back to reference Feyen BJ, Rao SS (2007) Functional disorders of defecation: evaluation and treatment. Curr Treat Options Gastroenterol 10:221–230CrossRefPubMed Feyen BJ, Rao SS (2007) Functional disorders of defecation: evaluation and treatment. Curr Treat Options Gastroenterol 10:221–230CrossRefPubMed
15.
go back to reference Hizawa K, Iida M, Suekane H et al (1994) Mucosal prolapse syndrome: diagnosis with endoscopic US. Radiology 191:527–530PubMed Hizawa K, Iida M, Suekane H et al (1994) Mucosal prolapse syndrome: diagnosis with endoscopic US. Radiology 191:527–530PubMed
16.
go back to reference Morio O, Meurette G, Desfourneaux V et al (2005) Anorectal physiology in solitary ulcer syndrome: a case-matched series. Dis Colon Rectum 48:1917–1922CrossRefPubMed Morio O, Meurette G, Desfourneaux V et al (2005) Anorectal physiology in solitary ulcer syndrome: a case-matched series. Dis Colon Rectum 48:1917–1922CrossRefPubMed
17.
go back to reference Felt-Bersma RJ, Poen AC, Cuesta MA et al (1997) Anal sensitivity test: what does it measure and do we need it? Cause or derivative of anorectal complaints. Dis Colon Rectum 40:811–816CrossRefPubMed Felt-Bersma RJ, Poen AC, Cuesta MA et al (1997) Anal sensitivity test: what does it measure and do we need it? Cause or derivative of anorectal complaints. Dis Colon Rectum 40:811–816CrossRefPubMed
Metadata
Title
A modified Delorme’s operation for the treatment of rectal mucosal prolapse
Authors
Yonggang Wang
Chunbao Zhai
Liyun Niu
Lijun Tian
Jianyong Yang
Zheng Hu
Publication date
01-05-2010
Publisher
Springer-Verlag
Published in
International Journal of Colorectal Disease / Issue 5/2010
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-009-0869-x

Other articles of this Issue 5/2010

International Journal of Colorectal Disease 5/2010 Go to the issue