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Session: ePoster Monitor 4-Other Neoplasia and Endoscopy and Pelvic Floor

eP318 - Comparing Perineal Approach for Complete Rectal Prolapse: Delorme versus Altemeier

Sunday, June 2, 2024
11:15 AM – 11:20 AM ET, USA
Location: Baltimore Convention Center, Room 318-320

    Author(s)

  • ZX

    Zhen-Peng Xu, Attending physician

    Department of Colorectal Surgery
    People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine
    Fuzhou, Fujian, China (People's Republic)

    Disclosure information not submitted.

  • GS

    Gui-Dong Sun, Chief physician

    Department of Colorectal Surgery
    The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing
    Nanjing, Jiangsu, China (People's Republic)

    Disclosure information not submitted.

    • ePoster Presenter(s)

  • Wan-jin Shao, Chief Physician

    Department of Colorectal Surgery
    The Affiliated Hospital of Nanjing University of Chinese Medicine
    The Affiliated Hospital of Nanjing University of Chinese Medicine
    Nanjing, Jiangsu, China (People's Republic)

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

Purpose/Background: The aim of our study was to compare the outcomes between the Delorme procedure and the Altemeier procedure for complete rectal prolapse.Methods/Interventions: The study population comprised patients with complete rectal prolapse who underwent Delorme procedure or Altemeier procedure between January 2013 and August 2019 at two tertiary center. We extracted data on patient age, sex, previous history of surgery for rectal prolapse, length of prolapsed rectum, length of hospital stay, complications, assessment of constipation and fecal continence, and recurrence rate.Results/Outcomes: 65 patients (male/female: 24/41, mean age: 53.2 years) underwent perineal repair surgery for complete rectal prolapse: 43 Altemeier and 22 Delorme. Among the 65 patients, 13 patients had undergone previous surgery for rectal prolapse. The median hospital stay was longer in Altemeier’s group [11.3 (4–15) days vs. 7.7 (3–15) days; p < 0.01]. The median length of prolapsed rectum was longer in Altemeier’s group too [9.2 (5–15) centimeters vs. 4.9 (3–7) centimeters; p < 0.01]. The median operating time was 164 minutes [Altemeier 189 (95–465) minutes vs. 114 (77–255) minutes; p < 0.01]. Postoperative complication rate was 12.3% (n = 8) [Altemeier 7 (16.3 %) vs. Delorme 1 (4.5 %), p > 0.05]. After a median follow-up of 60.4 (1–128) months, the rate of recurrent prolapse was 13.8 % (n = 9) [Altemeier 5 (11.6 %) vs. Delorme 4 (18.2 %) p > 0.05]. Improvement in fecal incontinence occurred in 76.6% of patients after Altemeier procedure, 57.1% after Delorme procedure. Improvement in constipation was recorded in 72.2%, 50% of patients after Altemeier, Delorme procedure, respectively. There was no mortality.Conclusion/

Discussion: Delorme and Altemeier procedure are safe and effective for the treatment of complete rectal prolapse with lower risks of complications and recurrence. In addition, redoing a perineal procedure may be safely performed for the treatment of the recurrent rectal prolapse after perineal procedure.