1,3,6) For hidden prolapse, the surgical treatment modalities may be Stapled Transanal Rectal Resection (STARR) procedure which is introduced as a new treatment approach or Delorme operation.
Delorme operation is a known method for the treatment of rectal prolapsed in which mucosa of prolapsing segment is removed and rectal muscle wall plicated.
In STARR method, an expensive instrument is used and its efficacy seems to be somewhere between 85% and 93%, but Delorme operation with success rate of 74% to 94% (15) is a more difficult method than STARR.
In this retrospective study the clinical outcome (resolving signs and symptoms of obstructive defecation syndrome) of different modalities, stapled transanal rectal resection, Delorme operation and electrotherapy of hemorrhoids are assessed.
81 patients with diagnosis of hidden rectal prolapse or prolapsing circumferential hemorrhoids were selected for surgical treatment by Delorme operation, stapled transanal rectal resection (STAAR) or 30 mAmp electrotherapy (13,14) according to the preference of consultant surgeon and clinical findings.
The number of patients for each modality were; 34 for STARR operation (age 36 to 63 with normal vaginal delivery of 2 to 5), 31 for Delorme operation (age 34 to 61 with normal vaginal delivery of 2 to 5) and 16 for electrotherapy (age 37 to 54 with normal vaginal delivery of 1 to 4).
Mean operating time was 43 minutes for STARR, 78 minutes for Delorme operation and 18 minutes for electrotherapy.
Delorme operation is used in the past for the treatment of hidden rectal prolapsed (22) and stapled transanal rectal resection was introduced as a new technology for the management of obstructive defecation syndrome.
STARR is compared with Delorme operation as a previously used method in the treatment of obstructed defecation syndrome (ODS).