{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T23:51:17Z","timestamp":1746489077809},"reference-count":36,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,2,27]],"date-time":"2013-02-27T00:00:00Z","timestamp":1361923200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2013,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The outcome of the internal Delorme's procedure (<jats:styled-content style=\"fixed-case\">IDP<\/jats:styled-content>) for obstructed defaecation was assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>From October 2001 to March 2009, 167 patients with obstructed defaecation associated with rectal intussusception were operated on. Patients were selected on the basis of validated constipation and continence scores, clinical examination and defaecography. Seventy\u2010six patients were treated by the <jats:styled-content style=\"fixed-case\">IDP<\/jats:styled-content> alone and 91 patients were treated by the <jats:styled-content style=\"fixed-case\">IDP<\/jats:styled-content> with a levatorplasty. Before surgery and after a mean\u00a0\u00b1\u00a0<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content> follow up of 3.0\u00a0\u00b1\u00a01.5\u00a0years, patients were assessed using the Cleveland Clinic Incontinence and Constipation Score (<jats:styled-content style=\"fixed-case\">CCIS<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">CCCS<\/jats:styled-content>), the Obstructed Defecation Score (ODS), faecal urgency and the Patient Assessment of Constipation Quality of Life (<jats:styled-content style=\"fixed-case\">PAC<\/jats:styled-content>\u2010QoL) questionnaire.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventeen (10.2%) patients developed a postoperative complication including fissure\u2010in\u2010ano (4.2%), proctalgia (3.0%), suture\u2010line dehiscence with stenosis (1.8%) and <jats:italic>Clostridium difficile<\/jats:italic> colitis (1.2%). Faecal urgency changed from 22% to 17.6% (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.754). Tenesmus fell from 53.9% to 17.1% (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). The <jats:styled-content style=\"fixed-case\">CCCS<\/jats:styled-content> and the <jats:styled-content style=\"fixed-case\">ODS<\/jats:styled-content> fell by 50% or more in 82.6% and 73.7% of the patients, respectively. The <jats:styled-content style=\"fixed-case\">CCIS<\/jats:styled-content> did not worsen significantly in patients who remained incontinent, and 45.7% of the previously incontinent patients regained normal continence. The <jats:styled-content style=\"fixed-case\">CCCS<\/jats:styled-content> decreased from 11 to 3 (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) in the patients treated by the <jats:styled-content style=\"fixed-case\">IDP<\/jats:styled-content> and from 12 to 3 (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) in the patients treated by the <jats:styled-content style=\"fixed-case\">IDP<\/jats:styled-content> with levatorplasty. The overall recurrence rate was 5.4%. The <jats:styled-content style=\"fixed-case\">PAC<\/jats:styled-content>\u2010QoL showed a reduction of anxiety\/depression and of physical and psychological discomfort (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The <jats:styled-content style=\"fixed-case\">IDP<\/jats:styled-content> is an effective and safe option for rectal outlet obstruction caused by rectal intussusception with excellent function and patient satisfaction.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.12092","type":"journal-article","created":{"date-parts":[[2012,12,5]],"date-time":"2012-12-05T23:02:06Z","timestamp":1354748526000},"update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Internal Delorme's procedure for rectal outlet 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