2015, Number 1
Procedimiento delorme para el tratamiento del prolapso rectal en niños
De la Torre-Mondragon L, Ruiz-Montañez A, Flores-Barrera A, Santos-Jasso A, De Giorgis-Stuven MA
Full text
Language: Spanish
References: 10
Page: 20-26
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ABSTRACT
Introduction: The rectal prolapse is the partial or total extrusion of the rectal mucosa through the anus. Interventions to resolve this include mechanical constraints, submucosal injections of sclerosing solutions, and several surgical techniques, without a clinically proven gold standard.Material and methods: Four male patients, aged 11 to 17 years old, with clinical diagnosis of total rectal prolapse were treated with the Delorme technique in Tertiary Care Hospital,. The approximate lengths of the prolapsed rectum were 12, 10, 12 and 13 cm respectively. The main symptoms were foreign body sensation and rectal bleeding in all cases, there was only one case of fecal incontinence, and another one with constipation.
Results: All patients had at least 6 months of clinical course (range 6-84 months), without improvement with medical treatment. In our study the operative time ranged from 90 to 240 minutes, no patient required blood transfusion, and no intraoperative complications were observed. The postoperative hospital stay was 3-12 days, no patient died, and only one patient reported recurrence of rectal prolapse at one year follow-up (with 84 months evolution of prolapse).
Discussion: The Delorme procedure is a transanal technique that completely solves the rectal prolapse with low morbidity and low operative risk (less damage to pelvic and hypogastric nerves in contrast with abdominal rectopexy), is associated with a marked improvement in anal continence, lower relapse rates, shorter hospital stay, early enteral feeding, and is more comfortable to patient, with little or no postoperative pain.
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