Comparative Study Between Delorme Operation With or Without Postanal Repair in Treatment of Complete Rectal Prolapse
Rectal Prolapse
About this trial
This is an interventional treatment trial for Rectal Prolapse focused on measuring Delorme operation,incontinence
Eligibility Criteria
Inclusion Criteria:
- complete rectal prolapse
Exclusion Criteria:
- pregnant female
- any patients with previous anal surgery
- pudendal nerve neuropathy
- anal fistula and sepsis or coagulopathy
Sites / Locations
- Ayman El Nakeeb
Arms of the Study
Arm 1
Arm 2
Active Comparator
Active Comparator
Group I delorme operation only.
delorme operation with post anal repair
A circumferential incision was made in the rectal mucosa approximately 1 cm away from the dentate line. Using electrocautery, the mucosa was stripped to the apex of the prolapse. The muscular layers of the rectal wall were reduced as the mucosa was stripped. Mucosal stripping continued past the apex of the prolapse and then continued inside the prolapsed segment to a point internally that is equivalent to the point of the initial mucosal incision. The underling muscle was plicated by vicryl 2/0.The muscle bite was taken longitudinally from 8 sides to reach a horizontal line of plication at the end. The mucosa was then reanastomosed. Postoperatively, minimal pain medication was required. Early ambulation was encouraged, and patients' diets were advanced as tolerated.
In group II : post anal repair was added by making transverse incision 7cm behind the anal canal.dissection of intersphincteric plain,plication of internal sphincter by using 3/0 vicryl.The levator ani and external sphincter were then sutured to each other by vicryl 2/0 behind the anal canal followed by skin closure without drain.