Evidence map›Paper›PMID 38041773›Full record

SynthesisLangenbeck's archives of surgery2023

Delorme's vs. Altemeier's in the management of rectal procidentia: systematic review and meta-analysis.

Pratik Bhattacharya, Mohammad Iqbal Hussain, Shafquat Zaman, Sophie Randle, Yousaf Tanveer, Nameer Faiz, Diwakar Ryali Sarma, Rajeev Peravali

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Langenbeck's archives of surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
2.7field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 11 citations in OpenAlex.

  1. Article
  2. Review
  3. Surgical approaches for complete rectal prolapse.World journal of gastrointestinal surgery · 2025
    Review
  4. Anal sphincter function in rectal intussusception and high and low "take-off" external rectal prolapse-A prospective observational study.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2024
    Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 1 country.

Pratik BhattacharyaDepartment of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, West Midlands, UK. pratik.bhattacharya@nhs.net.
Mohammad Iqbal HussainDepartment of General Surgery, Great Western Hospitals NHS Foundation Trust, Swindon, UK.
Shafquat ZamanDepartment of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, West Midlands, UK.
Sophie RandleDepartment of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, West Midlands, UK.
Yousaf TanveerDepartment of General Surgery, Craigavon Area Hospital, Portadown, Northern Ireland, UK.
Nameer FaizDepartment of General Surgery, The Dudley Group NHS Trust, Russells Hall Hospital, Dudley, West Midlands, UK.
Diwakar Ryali SarmaDepartment of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, West Midlands, UK.
Rajeev PeravaliDepartment of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, West Midlands, UK.
Sandwell & West Birmingham Hospitals NHS Trust · GBCraigavon Area Hospital · GBGreat Western Hospitals NHS Foundation Trust · GBRussells Hall Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRectal prolapse is a distressing condition for patients and no consensus exists on optimal surgical management. We compared outcomes of two common perineal operations (Delorme's and Altemeier's) used in the treatment of rectal prolapse.

methodsA systematic search of multiple electronic databases was conducted. Peri- and post-operative outcomes following Delorme's and Altemeier's procedures were extracted. Primary outcomes included recurrence rate, anastomotic dehiscence rate and mortality rate. The secondary outcomes were total operative time, volume of blood loss, length of hospital stay and coloanal anastomotic stricture formation. Revman 5.3 was used to perform all statistical analysis.

resultsTen studies with 605 patients were selected; 286 underwent Altemeier's procedure (standalone), 39 had Altemeier's with plasty (perineoplasty or levatoroplasty), and 280 had Delorme's. Recurrence rate [OR: 0.66; 95% CI [0.44-0.99], P = 0.05] was significantly lower and anastomotic dehiscence [RD: 0.05; 95% CI [0.00-0.09], P = 0.03] was significantly higher in the Altemeier's group. However, sub group analysis of Altemeier's with plasty failed to show significant differences in these outcomes compared with the Delorme's procedure. Length of hospital stay was significantly more following an Altemeier's operation compared with Delorme's [MD: 3.05, 95% CI [0.95 - 5.51], P = 0.004]. No significant difference was found in total operative time, intra-operative blood loss, coloanal anastomotic stricture formation and mortality rates between the two approaches.

conclusionsA direct comparison of two common perineal procedures used in the treatment of rectal prolapse demonstrated that the Altemeier's approach was associated with better outcomes. Future, well-designed high quality RCTs with long-term follow up are needed to corroborate our findings.

Indexed as

Digestive System Surgical ProceduresRectal ProlapseBlood Loss, SurgicalConstriction, PathologicHumansNeoplasm Recurrence, LocalRecurrenceTreatment OutcomeAltemeier’sDelorme’sRectal prolapseRectosigmoidectomy

Identifiers

PMID38041773
OpenAlexW4389270858

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.