Delorme's operation and sphincteroplasty for rectal prolapse and fecal incontinence |
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Authors: | M Pescatori A Interisano V M Stolfi M Zoffoli |
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Institution: | (1) Coloproctology Unit, Villa Flaminia, Via L. Bodio 58, I-00191 Rome, Italy, IT |
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Abstract: | Clinical and manometric results of Delorme's operation and sphincteroplasty were assessed retrospectively in patients undergoing
this procedure for fecal incontinence and rectal prolapse. A series of 33 patients (11 males, 22 females; aged 18–83 years,
mean 59) with external rectal prolapse were treated by Delorme's operation between 1989 and 1996. Mean follow-up was 39 months
(range 7–84). Sphincteroplasty was associated in 12 cases with severe fecal incontinence due to striated muscle defects. Good
results were achieved in 27 patients (79%); prolapse recurrence was observed in 6 (21%), the mean recurrence time being 9
months (range 1–24 months). There were no postoperative deaths. Minor complications occurred in 15 patients. Changes in preoperative
and postoperative manometric patterns were as follows (mean±SEM): voluntary contraction from 59±6.9 to 66±7.1 mmHg (P=0.05), resting tone from 33±5 to 32±4.3 mmHg, rectal sensation from 59±5 to 61±5.2 ml of air (n.s.). A solitary rectal ulcer
syndrome was detected in five patients. The histological pattern demonstrated pathological changes in 40% of cases. Fecal
incontinence was resolved in 6 of 20 cases (30%) and chronic constipation in 4 of 9 (44%). Failure (n=3) was related primarily to postoperative sepsis. The incontinence score showed a mean improvement of 35% decreasing, from
4.5±0.39 to 2.9±0.44 after surgery (P<0.01). In conclusion, Delorme's procedure did not lead to constipation and improved anal continence when associated with
sphincteroplasty.
Accepted: 20 January 1998 |
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Keywords: | Delorme's operation Sphincteroplasty Fecal incontinence |
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