Delorme's Procedure for Full-Thickness Rectal Prolapse; Does it Alter Anorectal Function.

Clinical and anorectal manometric results of Delorme's procedure for full-thickness rectal prolapse were assessed retrospectively. Thirty-seven patients with full-thickness rectal prolapse who were operated on with Delorme's procedure were included in the study. They were 11 males and 26 females with mean age of 54 ± 4.4 years (range 15-70 years) and mean follow-up period of 27 ± 4.6 months (15-48 months). The mean operative time was 65 ± 4.5 min (60-90 min); there was no mortality and blood loss was minimal. Mean hospital stay was 3.5 days (2-6 days). Outcomes of the procedure were satisfactory in 29 patients (78.4%). Dissatisfaction came from recurrence and persistence of fecal incontinence. Prolapse recurrence had been observed in six patients; three of them were treated by the same technique and showed no recurrence, and the others were treated by either mucosal resection (1) or abdominal resection rectopexy (2). Constipated patients showed improved symptoms in 7 of 10 cases. Of 11 patients who were incontinent preoperatively, seven patients became fully continent. Postoperatively, anorectal manometric studies (MRP, MSP, MTV, and UDV) showed significant improvement in all patients with intact RAIR. Delorme's operation, coupled with avoidance of abdominal procedures, is the treatment of choice of rectal prolapse in elderly frail patients and in patients with defecatory disorders.

Paternal occupational exposures and the risk of congenital malformations--a case-control study.

OBJECTIVES: This study examined the association between certain paternal occupational exposures during the periconceptional period and the risk of congenital malformations. MATERIALS AND METHODS: A case-control study was carried out from December 2009 to April 2010; on 242 congenital malformation cases and 270 controls. Paternal occupational exposure to certain workplace hazards was assessed by a detailed questionnaire to evaluate the occupational exposure for both fathers and mothers including pesticides, solvents, welding fumes, lead, working with video display terminals (VDTs) and computer monitors. In addition, the questionnaire assessed the presence of other risk factors such as consanguinity, smoking and history of any maternal diseases during the pregnancy with the child. RESULTS: The results revealed that the odds of having a child with congenital malformation was higher (P < 0.01) if the father was occupationally exposed to pesticides (OR: 3.42, 95% CI: 1.97-5.92), solvents (OR: 5.63, 95% CI: 2.77-11.42), or welding fumes (OR: 2.98, 0.99-8.54) during the periconceptional period. However, consanguinity (OR: 1.91, 95% CI: 1.25-2.92) was a risk factor of developing congenital malformations among offspring. CONCLUSION: Control of workplace exposures and adherence to threshold limit values of those hazards should be adopted to minimize the risk of developing congenital malformations among offspring.