Our Summary

This study looked at a specific problem that can occur after a type of rectal cancer surgery, called intersphincteric resection (ISR). Sometimes, part of the lining of the colon can slip out of place, causing discomfort and problems with bowel control. This is called a mucosal prolapse. The researchers wanted to see how well a surgical procedure called Delorme surgery, which is used to fix this issue, worked in patients who experienced this problem after ISR.

They looked at medical records of 720 patients who had ISR between 2001 and 2019 at a particular hospital. Out of these, 33 patients (or 4.5%) had Delorme surgery to correct a mucosal prolapse. The researchers found that bowel control improved a little bit after surgery, and discomfort around the anus got better in all 33 patients. However, the prolapse came back in 5 patients (or 15%), who then had to have the Delorme surgery again.

In conclusion, Delorme surgery can help patients with mucosal prolapse after ISR by improving their bowel control and reducing discomfort. However, there’s a chance the prolapse might come back, requiring further surgery.

FAQs

  1. What is a mucosal prolapse and how does it occur after ISR?
  2. How effective is Delorme surgery in treating a mucosal prolapse after ISR?
  3. What is the recurrence rate of mucosal prolapse after Delorme surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about rectal prolapse surgery is to follow post-operative care instructions carefully to ensure proper healing and to reduce the risk of complications. This may include following a specific diet, avoiding heavy lifting or strenuous activities, and taking prescribed medications as directed. It is also important to attend all follow-up appointments with your healthcare provider to monitor your recovery progress and address any concerns or issues that may arise.

Suitable For

Rectal prolapse surgery, including Delorme surgery, is typically recommended for patients who experience symptoms such as:

  1. Chronic rectal prolapse, where the rectum protrudes through the anus
  2. Difficulty controlling bowel movements
  3. Chronic constipation or fecal incontinence
  4. Rectal bleeding or discomfort
  5. Recurrent or severe mucosal prolapse following previous surgeries
  6. Failure of conservative treatments such as dietary changes, pelvic floor exercises, or medications

Patients with rectal prolapse who do not respond to conservative treatments or have significant symptoms that impact their quality of life may be candidates for surgical intervention. It is important for patients to discuss their symptoms and treatment options with a healthcare provider to determine the most appropriate course of action.

Timeline

Before rectal prolapse surgery, a patient may experience symptoms such as discomfort around the anus, issues with bowel control, and a mucosal prolapse where part of the colon lining slips out of place. These symptoms can impact a patient’s quality of life and may require surgical intervention.

After rectal prolapse surgery, such as Delorme surgery, patients may experience improvements in bowel control and a reduction in discomfort around the anus. However, there is a risk of the prolapse coming back, which may require additional surgery to address. Overall, the surgery can help alleviate symptoms and improve the patient’s overall quality of life, but long-term monitoring may be necessary to address any potential recurrence of the prolapse.

What to Ask Your Doctor

Some questions a patient should ask their doctor about rectal prolapse surgery include:

  1. What is the specific type of surgery being recommended for my rectal prolapse, and how does it work?
  2. What are the risks and potential complications associated with this surgery?
  3. How long is the recovery period, and what can I expect in terms of post-operative care and pain management?
  4. What are the chances of the prolapse recurring after surgery, and what options are available if it does?
  5. Will this surgery have any impact on my bowel control or other bodily functions?
  6. Are there any lifestyle or dietary changes I should make before or after the surgery to improve outcomes?
  7. How many times have you performed this type of surgery, and what is your success rate?
  8. Are there any alternative treatment options for rectal prolapse that I should consider?
  9. What should I do if I experience any unusual symptoms or complications after the surgery?
  10. How soon can I expect to return to normal activities and work after the surgery?

Reference

Authors: Narihiro S, Miura N, Nishizawa Y, Hasegawa H, Ikeda K, Teramura K, Tsukada Y, Sasaki T, Ito M. Journal: Surg Today. 2021 Jun;51(6):916-922. doi: 10.1007/s00595-020-02167-4. Epub 2020 Oct 23. PMID: 33095327