Our Summary

This research paper is about two surgical methods used to treat a condition called full-thickness rectal prolapse (FTRP), where the rectum protrudes from the body. This condition is particularly prevalent in China. The two methods studied are Delorme’s procedure and a modified version of a surgery called stapled transanal rectal resection (STARR).

The researchers looked back at the outcomes of these two procedures on 65 patients from December 2012 to May 2019. They compared the length of the operations, the amount of blood lost during surgery, any complications, how long the patients stayed in the hospital, and the effectiveness of the treatments in terms of recurrence of the condition, and improvements in symptoms of constipation and incontinence.

They found that both methods improved constipation and continence symptoms to a similar degree. However, the STARR procedure was faster and involved less blood loss. Despite this, there was no significant difference in recurrence rates between the two procedures, suggesting that both methods are valid treatment options for FTRP. The researchers concluded that while the two procedures have comparable outcomes, the STARR method has some advantages in terms of the operation itself.

FAQs

  1. What are the two surgical methods studied in this research for treating full-thickness rectal prolapse (FTRP)?
  2. What were the factors considered in comparing the Delorme’s procedure and the modified STARR procedure?
  3. Was there a significant difference in recurrence rates between the two procedures for FTRP?

Doctor’s Tip

A doctor might tell a patient undergoing rectal prolapse surgery to follow post-operative care instructions closely, including taking prescribed medications, avoiding strenuous activities, and maintaining good hygiene to prevent infection. They may also advise the patient to eat a high-fiber diet and stay hydrated to prevent constipation, which can worsen the condition. Regular follow-up appointments with the doctor will also be important to monitor healing and address any concerns.

Suitable For

Patients who are typically recommended rectal prolapse surgery are those who have full-thickness rectal prolapse (FTRP) and are experiencing symptoms such as constipation and incontinence that significantly impact their quality of life. These patients may have tried conservative treatments such as pelvic floor exercises or medications without success. Additionally, patients who are otherwise healthy and able to tolerate surgery may be candidates for rectal prolapse surgery. It is important for patients to discuss the risks and benefits of surgery with their healthcare provider to determine if it is the right option for them.

Timeline

Before rectal prolapse surgery, a patient may experience symptoms such as difficulty with bowel movements, leakage of stool, and a feeling of a bulge or protrusion from the rectum. They may undergo diagnostic tests such as a physical examination, colonoscopy, or imaging studies to confirm the diagnosis of rectal prolapse.

After surgery, the patient will typically stay in the hospital for a few days for monitoring and recovery. They may experience some pain and discomfort in the days following the procedure, which can be managed with pain medication. The patient will be advised to follow a specific diet and activity restrictions to aid in the healing process.

Over the weeks and months following surgery, the patient will gradually resume normal activities and will likely have follow-up appointments with their healthcare provider to monitor their recovery and address any concerns. The patient should see improvement in their symptoms of rectal prolapse, such as reduced protrusion of the rectum and improved bowel function.

What to Ask Your Doctor

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

  1. What are the potential risks and complications associated with the Delorme’s procedure and STARR procedure?
  2. How long is the recovery time for each surgery and what can I expect during the recovery process?
  3. What is the success rate of each procedure in terms of treating rectal prolapse and improving symptoms?
  4. Are there any long-term effects or considerations I should be aware of after undergoing either surgery?
  5. How do the costs of the Delorme’s procedure and STARR procedure compare, and will insurance cover the cost of the surgery?
  6. Are there any alternative treatments or non-surgical options available for treating rectal prolapse?
  7. How experienced are you in performing these surgeries, and what is your success rate with each procedure?
  8. Will I need to make any lifestyle changes or follow a special diet after the surgery?
  9. How soon after the surgery can I expect to see improvements in my symptoms of constipation and incontinence?
  10. Are there any specific follow-up appointments or post-operative care instructions I should be aware of?

Reference

Authors: Chen HX, Chen ZQ, Huang L, Han CP, Dou RX, Ren DL, Lin HC. Journal: Surg Innov. 2020 Oct;27(5):468-473. doi: 10.1177/1553350620929470. Epub 2020 Jun 8. PMID: 32510277