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INTRODUCTION: Le but de cette étude rétrospective est de montrer l'évolution du traitement du prolapsus total du rectum (PTR) sur deux périod es différentes. PATIENTS ET METHODES: Nous avons inclus et comparé les résultats de tous les patients opérés dans le service pour un PTR entre le 1er jan vier 1978 et le 31 décembre 1993 et entre le l " janvier 1995 et le 31 décembre RESULTATS: Cinquante quatre patients ont été opérés d'un PTR durant la première période, Nous avons réalisé 24 Delorme et 30, pp.20-94, 2002. ,
Soixante sept patients ont été opérés d'un PTR, 52 femmes et 9 hommes durant la seconde période, d'âge moyen était de 62 ans (21-93) Nous avons réalisé 35 Delorme ,
La mortalité était nulle pour les groupes Orr-Loygue et Frykman-Goldberg. La Morbidité était respectivement de 4% (1) et 26% (9) dans le groupe Delorme10) dans le groupe Orr-Loygue, et de 18% (2) dans le groupe Frykman-Goldberg. Aucun patient sur les deux périodes de l'étude dans le groupe Delorme ne présentait l'apparition ou l'aggravation d'une constipation, Loygue, ces chiffres étaient respecti vement de 10% (3) et 33% (6), et de 9% après un Frykman-Golberg. Le taux de récidive était respectivement de 25% (6) et 40% (14) dans le groupe Delorme, de 10% (3) et nul dans le groupe Orr-Loygue, et nul dans le groupe Frykman-Goldberg. CONCLUSION: L'intervention de Delorme doit être réservée aux sujets récusés pour une voie abdominale. Si le patient est incontinent et opérable par voie haute, nous choisissons une intervention d'Orr-Loygue. S'il est constipé, nous préférons réaliser une intervention de Frykman- Goldberg. Ces deux dernières techniques sont réalisables par laparoscopie et sous assistance robotisée, pp.13-17 ,