Comparison of Safety and Efficacy between Laparoscopic Ventral Rectopexy and Delorme’s Procedure for External Rectal Prolapse in Nonagenarians

Abstract

Objectives: This study evaluates the safety and efficacy of laparoscopic ventral rectopexy (LVR) in nonagenarian patients with external rectal prolapse (ERP) compared to Delorme’s procedure. Methods: We conducted a retrospective analysis of prospectively collected data, including nonagenarian patients who underwent either LVR or Delorme’s procedure, comparing outcomes such as morbidity, length of hospital stay (LOS), and recurrence rates. Results: Between September 2009 and August 2023, 22 patients (median age 91, range 90−94 years) underwent LVR, while 12 patients (median age 91, range 90−96 years) received Delorme’s procedure. Base-line characteristics, including sex ratio, parity, American Society of Anesthesiology grade, and Body Mass Index, did not significantly differ between the groups. LVR had a significantly longer operating time but lower blood loss than Delorme’s procedure. Postoperative LOS was significantly shorter for LVR patients (median 1, range 1−3 days) compared to Delorme’s procedure patients (median 2.5, range 1−13 days; P = 0.001). Notably, no significant morbidity occurred in the LVR group, while one case of delirium and an-other of solitary rectal ulcer syndrome were observed in the Delorme’s procedure group. Recurrence rates were lower in the LVR group, with no recurrences during a median follow-up of 23 months (range 1−65 months), compared to one recurrence at 2 months during a median follow-up of 34 months (range 1−96 months) in the Delorme’s procedure group. Conclusions: LVR is a safe and effective surgical option for nonagenarian ERP patients, showing favorable outcomes in terms of morbidity, LOS, and recurrence rates compared to Delorme’s procedure.