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Perineal Approach to External Rectal Prolapse: The Delorme Procedure

  • Gian Andrea Binda
  • Alberto Serventi

Abstract

The Delorme procedure is a perineal technique for repair of full-thickness rectal prolapse first described by the French military surgeon Edmond Delorme in 1900 [1]. This procedure includes stripping the mucosa of the prolapsed rectum and sutured plication of the bare muscle remnant, which collapses the wall like an accordion. The mucosa is then reapproximated to seal the anastomosis. The technique Delorme described is simple, may be performed under regional anaesthesia, is performed through a perineal approach and does not require a bowel resection and anastomosis. However, the Delorme procedure was not commonly used until a report by Uhlig and Sullivan [2] in 1979, after which it gained increased popularity. The simplicity of the approach and lack of major complications have made it popular with both surgeons and patients over the past 20 years and has led to its use as a primary operation for rectal prolapse.

Keywords

Pelvic Floor Faecal Incontinence Rectal Prolapse Perineal Approach Complete Rectal Prolapse 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Delorme E (1900) Sur le traitement des prolapsus du rectum totaux par l’excision de la muquese rectale au rectal-colique. Bull Mem Soc Chir Paris 26:499–518Google Scholar
  2. 2.
    Uhlig BE, Sullivan ES (1979) The modified Delorme operation: its place in surgical treatment for massive rectal prolapse. Dis Colon Rectum 22:513–521PubMedCrossRefGoogle Scholar
  3. 3.
    Lechaux JP (2002) Trattamento chirurgico del prolasso rettale completo dell’adulto. Encycl Med Chir. Tecniche Chirurgiche-Addominale. Elsevier, Paris, Pub med 40–710Google Scholar
  4. 4.
    Karulf RE, Madoff RD, Goldberg SM (2001) Rectal prolapse. Curr Probl Surg 38:771–832PubMedGoogle Scholar
  5. 5.
    Houry S (2000) Opération de Delorme pour prolapsus rectal. J Chir 137:338–341Google Scholar
  6. 6.
    Jacobs LK, Lin YJ, Orkin BA (1997) The best operation for rectal prolapse. Surg Clin North Am 77:49–70PubMedCrossRefGoogle Scholar
  7. 7.
    Lechaux JP, Lechaux D, Perez M (1995) Results of Delorme’s procedure for rectal prolapse: advantages of a modified technique. Dis Colon Rectum 38:301–307PubMedCrossRefGoogle Scholar
  8. 8.
    Prasad ML, Pearl RK, Abcarian H et al (1986) Perineal proctectomy, posterior rectopexy, and postanal levator repair for the treatment of rectal prolapse. Dis Colon Rectum 29:547–552PubMedCrossRefGoogle Scholar
  9. 9.
    Friedman R, Muggia-Sulam M, Freund HR (1983) Experience with one-stage perineal repair of rectal prolapse. Dis Colon Rectum 26:789–791PubMedCrossRefGoogle Scholar
  10. 10.
    Madiba TE, Baig MK, Wexner SD (2005) Surgical management of rectal prolapse. Arch Surg 140:63–73PubMedCrossRefGoogle Scholar
  11. 11.
    Pascual Montero JA, Martinez Puente MC, Pascual I et al (2006) Complete rectal prolapse clinical and functional outcome with Delorme’s procedure. Rev Esp Enferm Dig 98:837–843PubMedCrossRefGoogle Scholar
  12. 12.
    Marchal F, Bresler L, Ayav A et al (2005) Long-term results of Delorme’s procedure and Orr-Loygue rectopexy to treat complete rectal prolapse. Dis Colon Rectum 48:1785–1790PubMedCrossRefGoogle Scholar
  13. 13.
    Serventi A, Sallustio P, Lobascio P, Binda GA (2005) Role of levatorplasty in total rectal prolapse treatment using perineal approach. II Joint Meeting ECCP/ EACP. I Congress SICCR. Medimond, Bologna, pp 155–157Google Scholar
  14. 14.
    Watts AMI, Thompson MR (2000) Evaluation of Delorme’s procedure as a treatment for full thickness rectal prolapse. Br J Surg 87:218–222PubMedCrossRefGoogle Scholar
  15. 15.
    Liberman H, Hughes C, Dippolito A (2000) Evaluation and outcome of the Delorme procedure in the treatment of rectal outlet obstruction. Dis Colon Rectum 43:188–192PubMedCrossRefGoogle Scholar
  16. 16.
    Pescatori M, Interisano A, Stolfi VM et al (1998) Delorme’s operation and sphincteroplasty for rectal prolapse and faecal incontinence. Int J Colorectal Dis 13:223–227PubMedCrossRefGoogle Scholar
  17. 17.
    Yakut M, Kaymakciioglu N, Simsek A et al (1998) Surgical treatment of rectal prolapse: a retrospective analysis of 94 cases. Int Surg 83:53–55PubMedGoogle Scholar
  18. 18.
    Agachan F, Reissman P, Pfeifer J et al (1997) Comparison of three perineal procedure for the treatment of rectal prolapse. South Med 90:925–932Google Scholar
  19. 19.
    Kling KM, Rongione AJ, Evans B et al (1996) The Delorme procedure: a useful operation for complicated rectal prolapse in the elderly. Am Surg 62:857–860PubMedGoogle Scholar
  20. 20.
    Oliver GC, Vachon D, Eisenstat TE et al (1994) Delorme’s procedure for complete rectal prolapse in severely debilitated patient: an analysis of 41 patients. Dis Colon Rectum 37:461–467PubMedCrossRefGoogle Scholar
  21. 21.
    Senapati A, Nicholls RJ, Thomson JPS et al (1994) Results of Delorme’s procedure for rectal prolapse. Dis Colon Rectum 37:456–460PubMedCrossRefGoogle Scholar
  22. 22.
    Tobin SA, Scott IHK (1994) Delorme operation for rectal prolapse. Br J Surg 81:1681–1684PubMedCrossRefGoogle Scholar
  23. 23.
    Sielezneff I, Malouf A, Cesari J et al (1999) Selection criteria for internal rectal prolapse repair by Delorme’s transrectal excision. Dis Colon Rectum 42:367–373PubMedCrossRefGoogle Scholar
  24. 24.
    Plusa SM, Charig JA, Balaji V et al (1995) Physiological changes after Delorme’s procedure for full-thickness rectal prolapse. Br J Surg 82:1475–1478PubMedCrossRefGoogle Scholar
  25. 25.
    Mann CV, Hoffman C (1988) Complete rectal prolapse: the anatomical and functional results of treatment by an extended abdominal rectopexy. Br J Surg 75:34–37PubMedCrossRefGoogle Scholar
  26. 26.
    McCue JL, Thompson JPS (1991) Clinical and functional results of abdominal rectopexy for rectal prolapse. Br J Surg 78:921–923PubMedCrossRefGoogle Scholar
  27. 27.
    Speakman CT, Madden MV, Nichols RJ et al (1991) Lateral ligament division during rectopexy causes constipation but prevents recurrence: results of a prospective randomised study. Br J Surg 78:1431–1433PubMedCrossRefGoogle Scholar
  28. 28.
    Delemarre JB, Gooszen HG, Kruyt RH (1991) The effect of posterior rectopexy on fecal continence. Dis Colon Rectum 34:311–316PubMedCrossRefGoogle Scholar
  29. 29.
    Frykman HM, Goldberg SM (1969) The surgical treatment of rectal procidentia. Surg Gynecol Obstet 129:1225–1230PubMedGoogle Scholar
  30. 30.
    McKee RF, Lauder JC, Poon FW et al (1992) A prospective randomized study of abdominal rectopexy with and without sigmoidectomy in rectal prolapse. Surg Gynecol Obstet 174:145–148PubMedGoogle Scholar
  31. 31.
    Meyers JO, Wong WD, Rothenberg DA et al (1990) Rectal prolapse in male. Implications for management. Dis Colon Rectum 33:28Google Scholar
  32. 32.
    Gorgun E, Remzi FH, Goldberg JM et al (2004) Fertility is reduced after restorative proctocolectomy with ileal pouch anal anastomosis: a study of 300 patients. Surgery 136:795–803PubMedCrossRefGoogle Scholar
  33. 33.
    Takesue Y, Yokoyama T, Murakami Y et al (1999) The effectiveness of perineal rectosigmoidectomy for the treatment of rectal prolapse. Surg Today 29:290–293PubMedCrossRefGoogle Scholar
  34. 34.
    Altomare DF, Boccasanta P (2000) Algoritmo decisionale per il trattamento del prolasso rettale completo. UCP News 4:43–44Google Scholar
  35. 35.
    Gourgiotis S, Baratsis S (2007) Rectal prolapse. Int J Colorectal Dis 22:231–243PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2008

Authors and Affiliations

  • Gian Andrea Binda
    • 1
  • Alberto Serventi
    • 1
  1. 1.Department of SurgeryGalliera HospitalGenoaItaly

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