RESUMO
BACKGROUND: Rectal prolapse is a distressing and socially disabling condition. controversy exists regarding the preferred surgical technique for the treatment of complete rectal prolapse. OBJECTIVE: We compared Delorme operation alone or with postanal repair and levatroplasty in treating complete rectal prolapse. METHODS: Consecutive patients treated for rectal prolapse at our colorectal unit were evaluated for inclusion. Participants were randomly allocated to receive Delorme operation only (GI), or Delorme operation with postanal repair and levatorplasty (GII). MAIN OUTCOME MEASURES: The primary outcome measure was recurrence rate; secondary outcomes included improvement of constipation, incontinence, operative time, anal manometery and postoperative complications. RESULTS: Eighty-two consecutive patients with rectal prolapse were randomized. There was a significant difference between the two groups with longer operative time in group II. Recurrence rate after one year was (14.28% in GI, and 2.43% in GII, respectively (P = 0.043). Constipation improved in group I & II but there was a significant difference in constipation scores postoperatively between the two groups. There was improvement in continence mechanism in both groups postoperatively but being higher in group II and this produce a significant statistical difference (0.004). Mean satisfaction score was significantly higher in group II than group I. Both groups succeed to produce a significant change in resting and squeeze pressure before & after the operation. CONCLUSIONS: Delorme operation seems to be an effective procedure for treating complete rectal prolapse especially if combined with postanal repair and levatorplasty. CLINICAL TRIAL REGISTRATION: NCT01656369.
