EP733 - Outcomes of Delorme's procedure for rectal prolapse in young indivisual: A retrospective cohort analysis in an apex tertiary referral centre

Purpose/Background: Rectal prolapse remains a debilitating problem for many individuals. Various procedures have been described for its correction but none of them have provided consistent results. Delorme's procedure traditionally been favoured for older patients due to its low complication rates and being a perineal procedure can be easily done in moribund patients. However, its role in young individuals is not well elucidated.

Methods/Interventions: All Patients underwent Delorme's procedure for full thickness rectal prolapse in a unit of a tertiary care academic centre between 2017 and 2024 were reviewed. We did a retrospective analysis of a prospectively maintained database and a prospective follow up of these patients. Patients were followed up physically or through phone call. All patients had undergone standard Delorme's procedure with circumferential mucosectomy and plication under general anaesthesia in prone position. Standard definitions were used for rectal prolapse, anal incontinence and constipation. Data was presented as mean (SD) or median (IQR) as applicable. Student's t test was used for comparing continuous variables between the groups. Chi-square or Fisher's exact test was used for comparing qualitative data. A two tailed p-value of < 0.05 will be considered significant. Ethical clearance was obtained from the institutional ethics committee.

Results/Outcomes: A total of 33 patients underwent Delorme's procedure. At baseline 56.3% of the patients were men rest women. At baseline, all 33 patients (100%) complained of mass per rectum, 11 patients (33.3%) complained of faecal incontinence, 6 patients (18.2%) of constipation, 2 patients (6.1%) of bleeding, 3 patients (9.1%) complained of straining and manual evacuation, and none of them were using laxatives chronically.

Average age of the patients was 42.03 years. 21 patients were under 50 years of age. Mean duration of follow-up being 4.8 ± 2.3 years. The mean Wexner score improved from baseline value of 4.78 ± 5.51 to 2.6 ± 4.24 at follow-up showing significant improvement (p=0.02). There was significant symptomatic improvement following surgery. Recurrence was seen in 8 of the patients of whom 4 of them underwent Delorme's procedure again. 2 patients had persistent bleeding after the procedure which self-resolved after 3 months.

Conclusion/Discussion: Younger patients may also be offered Delorme's procedure for complete rectal prolapse. In case of recurrence, there is always a chance to perform a re-Delorme's. The extent of prolapse should be a deciding factor when choosing the procedure than just age.