Results of surgical treatment of rectal outlet obstruction with internal Delormeprocedure: P003


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Abstract

Aim:We report our experience with the internal Delorme with or without levatorplasty for obstructed defecation (OD).Method:Retrospective study using aprospective date-base of 167 patients with OD caused by rectal intussusception (18) associated with rectocele (111) or rectocele only (38). Seventy-six patients (Group-1) were treated by the internal Delorme, combined with a levatorplasty in 91 (Group-2). Patients were evaluated using the CCCS, ODS-score and PAC-QoL. The mean follow-up was 3.22 ± 1.50 and 2.75 ± 1.47 years respectively (P = 0.046)Results:Eighteen (10.8%) patients developed postoperative complications (fissure in 7 (4.2%),proctalgia in 5 (3.0%), suture-line dehiscence/stenosis in three (1.8%)) without statistically differences in the 2 groups (P = 0.109). Fecal urgency changed from 17.1% to 19.7% (P = 0.754) in group-1 and from 22.0% to 17.6% (P = 0.503) in group-2. Tenesmus diminished from 43.4% to 17.1% (P < 0.001) in group-1; 52.7% to 9.9% (P < 0.001) in group-2. The CCCS and ODS decreased significantly (P ≤ 0.001). The number of evacuations increased (P ≤ 0.001). PAC-QoL showed a reduction of anxiety/depression, physical discomfort and psychological discomfort (P ≤ 0.001).Conclusion:The internal Delorme is an option for OD caused by rectal intussusception with or without rectocele, with excellent functional results, patient satisfaction and low risk of recurrentprolapse and morbidity.

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