Delorme’s Procedure for Complete Rectal Prolapse: Does It Still Have It’s Own Role?
이수호, 계봉현, 김형진, 조현민, 김준기,
소속 상세정보
이수호 ( Lee Soo-Ho )
Catholic University St. Vincent’s Hospital Department of Surgery
계봉현 ( Kye Bong-Hyeon )
Catholic University School of Medicine St. Vincent Hospital Department of Surgery
김형진 ( Kim Hyung-Jin )
Catholic University School of Medicine St. Vincent Hospital Department of Surgery
조현민 ( Cho Hyeon-Min )
Catholic University School of Medicine St. Vincent Hospital Department of Surgery
김준기 ( Kim Jun-Gi )
Catholic University School of Medicine Seoul St. Mary’s Hospital Department of Surgery
KMID : 0356720120280010013
Abstract
Purpose: Although there are more than a hundred techniques, including the transabdominal and the perineal approaches, for the repair of the rectal prolapsed, none of them is perfect. The best repair should be chosen not only to correct the prolapse but also to restore defecatory function and to improve fecal incontinence throughout the patient’s lifetime. The aim of this retrospective review is to evaluate clinical outcomes of the Delorme’s procedure for the management of the complete rectal prolapse.
Methods: A total of 19 patients (13 females and 6 males) with complete rectal prolapses were treated by using the Delorme’s procedure in St. Vincent’s Hospital, The Catholic University of Korea, from February 1997 to February 2007. Postoperative anal incontinence was evaluated using the Cleveland Clinic Incontinence Score.
Results: All 19 patients had incontinence to liquid stool, solid stool, and/or flatus preoperatively. Three (15.8%) patients reported recurrence of the rectal prolapse (at 6, 18, 29 months, respectively, after the operation). Information on postoperative incontinence was available for 16 of the 19 patients. Twelve of the 16 patients (75%) reported improved continence (5 [31.3%] were improved and 7 [43.7%] completely recovered from incontinence) while 4 patients had unchanged incontinence symptoms. One (6.3%) patient who did not have constipation preoperatively developed constipation after the operation.
Conclusion: The Delorme’s procedure is associated with a marked improvement in anal continence, relatively low recurrence rates, and low incidence of postoperative constipation. This allows us to conclude that this procedure still has its own role in selected patients.
키워드
Incontinence; Delorme’s procedure; Rectal prolapse
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