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. 2025 Mar 28;282(6):939-945.
doi: 10.1097/SLA.0000000000006708. Online ahead of print.

Laparoscopic Resection Rectopexy Versus Delorme's Procedure In Full-Thickness Rectal Prolapse - A Randomized Multicenter Trial (DELORES-RCT)

Florian Herrle  1 , Flavius Sandra-Petrescu  1 , Simone Rothenhoefer  2 , Julia Hardt  1 , Steffen Seyfried  1 , Andreas Joos  3 , Alexander Herold  3 , Dieter Bussen  3 , Stefan Post  1 , Marion Brunner  4 , Alois Fürst  4 , Gianluca De Santo  5 , Robert Siegel  6 , Martin Strik  5 , Michael Sprossmann  7 , Eugen Berg  7 , Andreas Ommer  8 , Martin K Walz  9 , Claudia Benecke  10 , Ralf Bouchard  10 , Tobias Keck  10 , Dirk Weimann  11 , Thomas Schiedeck  11 , Nicolas Demartines  12 , Dieter Hanloser  12 , Anja Sander  13 , Lukas D Sauer  13 , Christina Klose  13 , Meinhard Kieser  13 , Markus Diener  14 , Rosa Klotz  14 , Christoph Reissfelder  1 , Peter Kienle  15
Affiliations

Laparoscopic Resection Rectopexy Versus Delorme's Procedure In Full-Thickness Rectal Prolapse - A Randomized Multicenter Trial (DELORES-RCT)

Florian Herrle et al. Ann Surg. .

Abstract

Objective: The DELORES trial investigated whether laparoscopic resection rectopexy (LRR) is superior to Delorme's procedure (DP) in full-thickness rectal prolapse.

Summary of background data: Multiple perineal and transabdominal procedures are current practice for rectal prolapse surgery. Evidence from adequately designed randomized studies addressing the question of which of these procedures are superior in terms of recurrence and bowel function is lacking.

Methods: DELORES was a randomized, observer-blinded, expertise-based multicenter trial. Patients with full-thickness rectal prolapse were eligible. Primary outcome was time to recurrence of full-thickness rectal prolapse within 24 months after primary surgery. Main secondary endpoints were morbidity, hospital stay, quality of life, constipation and fecal incontinence. (DRKS00000482).

Results: A total of 358 patients were screened between September 2010 and January 2016. Based on screening, 70 patients were randomized and 65 were included in the analysis (33 LRR and 32 DP procedures). Median follow-up was 23.9 months. Analysis of the primary outcome showed that LRR was superior to DP ( P =0.0012). During the 24-month follow-up, 8.2% of patients in the LRR group had a full-thickness prolapse recurrence versus 42.8% in the DP group. Median time to recurrence was 11.9 months for LRR and 8.2 months for DP. Median duration of surgery was 212 min (LRR) versus 77 min (DP). Overall postoperative morbidity was low. The reoperation rate was higher for DP (0% LRR vs. 33.3% DP). Quality of life (FIQL) and incontinence scores (Wexner) were more favorable for LRR at 24-month follow-up.

Conclusion: Laparoscopic resection rectopexy is superior to Delorme's procedure in terms of recurrence and has favorable functional results.

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Conflict of interest statement

Conflict of Interest declaration : The authors declare that they have no affiliations with or involvement in any organization or entity with any financial interest in the subject matter or materials discussed in this manuscript.

Figures

FIGURE 1
FIGURE 1
CONSORT flowchart of patient recruitment. Red: patients withdrawn from the study and ITT analysis. ITT indicates intention-to-treat.
FIGURE 2
FIGURE 2
Primary endpoint: time to recurrence. Kaplan–Meier plot for comparison of time to recurrence (stratified log-rank test). DP indicates Delorme’s procedure; LRR, laparoscopic resection rectopexy.
FIGURE 3
FIGURE 3
Secondary endpoints: bowel function (incontinence and constipation) and bowel-specific quality of life (FIQL). Missing data at the 24-month follow-up for each of these 4 scores: DEL/DP: n=7/32 (22%); LRR: n=11/33 (33%). DEL/DP indicates Delorme’s procedure; LRR, laparoscopic resection rectopexy.
See this image and copyright information in PMC

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