Surgical treatment of rectal prolapse in pediatric patients: A single- center experience from Iran
Iranian Journal of Pediatric Surgery,
Vol. 1 No. 1 (2015),
1 September 2015
Introduction: Rectal prolapse refers to extrusion of mucosa or the full thickness wall of the rectum through the anal sphincter, which is more common between infancy and 4 years of age and has a high incidence in the first year of life. It is considered as a sign of an underlying clinical condition causing an increased intra‑abdominal pressure, pelvic floor weakness or poor root innervations as seen in Hirschsprung’s disease; and not a distinct entity. Also many different methods of surgery exist for treating this condition. We reviewed our experience with regard to treatment and outcome of rectal prolapse in a tertiary center.
Materials and Methods: All patients with rectal prolapse who were managed at Mofid Children’s Hospital between 2005 and 2014 were evaluated. Clinical information was obtained from their hospital records. Main study variables were age and sex, the type of prolapse, clinical findings and type of surgery performed and complications.
Results: Of a total 111 patients, 82 (73.9%) were boys and 29 (26.1%) were girls with a mean age of 3.5 yrs ± 2.3 SD at the time of diagnosis and a mean age of 4.3 yrs ± 3SD at the time of surgery. The most frequent type of rectal prolapse was mucosal. Conservative treatment mainly consisting of constipation therapy was carried out in 24.3% of our patients. The most common surgical procedures used in our center were Lockhart mummery and excision of the redundant mucosa (32.4%& 23.4% respectively). Performance of other methods depended on the attending surgeon’s preference. Almost 90% of our patients showed no post operative complications. In our study we had 9 cases with recurrent prolapse after surgery. The mean hospital stay was 3.9± 3.2 (ranging from 1 to 24 days).
Conclusions: According to the obtained results, it could be concluded that treatment of rectal prolapse would result in improvement in nearly nine out of ten children and a low rate of postoperative complication are expected. However further studies should be performed to obtain more definite results.
- rectal prolapse
- anorectal malformation
- pediatric surgery
Shin EJ: Surgical treatment of rectal prolapse.J Korean Soc Coloproctol 2011; 27(1):5-12.
Goldstein SD, Maxwell PJ 4th: Rectal prolapse. Clin Colon Rectal Surg 2011; 24(1):39-45.
O'Brien DP 4th: Rectal prolapse. Clin Colon Rectal Surg 2007; 20(2):125-32.
Yoon SG: Rectal prolapse: review according to the personal experience. J Korean Soc Coloproctol 2011; 27(3):107-13.
Zganjer M, Cizmic A, Cigit I, et al: Treatment of rectal prolapse in children with cow milk injection sclerotherapy: 30-year experience. World J Gastroenterol 2008;14(5):737-40.
Calkins CM, Oldham KT: Acquired anorectal disorders. In: George W. Holcomb III, J. Patrick Murphy. Daniel J. Ostile. ASHCRAFT’s Pediatric Surgery. London, New York, Oxford Philadelphia St Louis Sydney Toronto, ELSEVIER SUNDERS, 2014, pp 526-528.
Siafakas C, Vottler TP, Andersen JM: Rectal prolapse in pediatrics. Clin Pediatr 1999; 38(2):63-72.
Antao B, Bradley V, Roberts JP, et al: Management of rectal prolapse in children. Dis Colon Rectum 2005; 48(8):1620-5.
Madiba TE, Baig MK, Wexner SD: Surgical management of rectal prolapse. ArchSurg 2005; 140(1):63-73.
Flum AS, Golladay ES, Teitelbaum DH: Recurrent rectal prolapse following primary surgical treatment. Pediatr Surg Int 2010; 26(4):427-31.
Poole GV Jr, Pennell TC, Myers RT, et al: Modified Thiersch operation for rectal prolapse. Technique and results. Am Surg 1985; 51(4):226-9.
Freeman NV: Rectal prolapse in children.J R Soc Med 1984; 77 Suppl 3:9-12.
Zempsky WT, Rosenstein BJ: The cause of rectal prolapse in children. Am J Dis Child 1988; 142(3):338-9.
Laituri CA, Garey CL, Fraser JD, et al: 15-Year experience in the treatment of rectal prolapse in children. J Pediatr Surg 2010; 45(8):1607-9.
Fahmy MA, Ezzelarab S: Outcome of submucosal injection of different sclerosing materials for rectal prolapse in children. Pediatr Surg Int 2004; 20(5):353-6.
Marderstein EL, Delaney CP: Surgical management of rectal prolapse. Nat Clin Pract Gastroenterol Hepatol 2007; 4(10):552-61.
Ismail M, Gabr K, Shalaby R: Laparoscopic management of persistent complete rectal prolapse in children. J Pediatr Surg 2010; 45(3):533-9.
Scheye T, Marouby D, Vanneuville G: Total rectal prolapse in children. Modified Lockhart-Mummery operation. Presse Med 1987; 16(3):123-4.
Balde I, Mbumbe-King A, Vinand P: The Lockhart-Mummery technique in the treatment of the total rectal prolapse among children. Concerning 25 cases. Chir Pediatr 1979; 20(5):375-7.
Scheye T, Vanneuville G, Marouby D, et al: Total rectal prolapse in children. Diagnostic and therapeutic trends. Statistics apropos of 52 cases. J Chir (Paris) 1996; 133(1):16-9.
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