Our Experience in Management of Complete Rectal Prolapse in Children by Delorme Procedure
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- Category: Vol. 84, December 2016
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Our Experience in Management of Complete Rectal Prolapse in Children by Delorme Procedure, MOHAMED E. ERAKI
Abstract
Aim of the Work: The aim of the work is to study the functional and surgical outcome of Delorme procedure for the management of complete rectal prolapse in children at the Pediatric Surgery Department, Zagazig University Hospitals.
Patients and Methods: This study was done on the records of 46 patients with complete rectal prolapse with a mean age of 7 to 15 years in Pediatric Surgery Unit, Faculty of medicine Zagazig University Hospitals in the period between 2010 to 2013. We used Fecal incontinence severity index (FISI) and Fecal Incontinence Quality of life (FIQL) questionnaires to evaluate the severity of the condition and impact on quality of life (QOL). The primary outcome was defined as complete recovery of continence, and partial recovery was defined as improvement in either type or frequency of incontinence or both. Recurrence was defined as recurrent incontinence after complete recovery. The secondary outcome was defined as change in the impact of incontinence on patients quality of life as assessed by the (FIQL).
Results: The mean operative time was 50 to 70min, the mean time until the first oral intake was 8 to 12h, and the mean post operative hospital stay was 36 to 48h. Surgical repair of rectal prolapse by Delorme procedure showed a favorable outcome in the form of significantly higher postop-erative scores of individual items of the (FIQL) questionnaire, with a significant higher post operative total (FIQL) compared with pre operative scores .Throughout the follow-up duration of 2 years, 30 patients (65.2%) showed complete recovery, 10 patients (21.7%) showed only partial improvement and 6 patients (13.04%) developed recurrence of gas incontinence 6 months after the disappearance of his incontinence.
Conclusion: The management of complete rectal prolapse by Delorme procedure is safe and effective with high rate of complete recovery and improvement of continence and fecal impaction with increase quality of life scores.