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PWE-392 Need for further surgery after delormes procedure for rectal prolapse in elderly patients
  1. MI Aslam,
  2. E-J Dilley,
  3. J Yeung,
  4. S Chaudhri,
  5. A Scott,
  6. A Miller
  7. Leicester Specialist Colorectal Advisory Group
  1. Department of Colorectal Surgery, University Hospitals of Leicester NHS Trust, Leicester, UK

Abstract

Introduction Rectal prolapse is a profoundly disabling condition, occurring mainly in elderly females. Delormes procedure is often the preferred operative option for high risk elderly patients due to its minimal invasive nature and minimal postoperative morbidity. A recent randomised control trial looking at the different operative procedure for rectal prolapse has quoted rectal prolapse recurrence after Delormes procedure as high as 46% at 5 years. Whether that high recurrence rates correlates with the need of further surgery is not known. We aimed to analyse rectal prolapse recurrence and further surgery rates for patients undergoing Delormes procedure in our institution.

Method All consecutive adult patients undergoing Delormes procedure between April, 2000 – December, 2014 at the University Hospitals of Leicester NHS Trust were reviewed. This was a retrospective study. Patients were analysed for mode of surgery, 30 day post-operative mortality, post-operative length of hospital stay, clinically detected recurrence and further rectal prolapse surgery.

Results 109 patients (median age = 79 years, female n = 102, male n = 7) underwent Delormes procedure over the 14 years. Ninety nine (91%) patients had planned surgery and ten (9%) patients had an urgent operation after being admitted via emergency admission route. Median follow up for all the patients was 4 years and 69 patients were alive at the time of analysis. 30 day post-operative mortality was 2.75% and median length of hospital stay after surgery was 4.5 days. 15 (13.7%) patients had a clinically detected rectal prolapse recurrence during the follow up period, 12 (11%) underwent further surgery for their rectal prolapse (redo Delormes n = 4, Altemeier–s procedure n = 5, abdominal rectopexy n = 3) and 3 patients did not undergo further surgery.

Conclusion Delormes procedure remains safe and an effective procedure to treat rectal prolapse in elderly patients as clinically significant recurrence rates are low.

Disclosure of interest None Declared.

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