Evaluating the Efficacy and Safety of Perirectal Sclerotherapy with 50% Dextrose Injection as a Primary Surgical Procedure for Rectal Prolapse in Pediatric Patients: A Clinical Trial

Abstract

Background: Rectal prolapse is a condition where the rectum protrudes through the anus. This study aimed to evaluate the effectiveness of perirectal sclerotherapy using a 50% dextrose injection as a primary surgical procedure for rectal prolapse in children under 14 years of age. Objectives: The purpose of the study was to evaluate the efficacy, safety, and advantages of perirectal sclerotherapy using a 50% dextrose injection as a primary surgical procedure for rectal prolapse in pediatric patients. Methods: This clinical trial involved 40 patients diagnosed with rectal prolapse, who were treated with perirectal sclerosant (dextrose 50%) injection. All patients had grade III or grade IV rectal prolapse. Three injections of 50% dextrose were administered into the area around the anus and the submucosa, 2 - 3 cm above the dentate line, while the patient was in the lithotomy position. Injections were given at the 3, 6, and 9 o'clock positions around the anus (1 cc/kg at the 6 o'clock position and 0.5 cc/kg at the 3 and 9 o'clock positions). The patients were followed up for recurrence and complications at three-month and six-month intervals, respectively. Results: The patients had an average age of 5.62 years, with the majority being male (77.5%). The average time between symptom onset and sclerotherapy administration was 6.60 ± 1.73 months. Five patients experienced edema around the anus and injection site on the first day of observation. At the second examination (one week later), only one patient had cellulitis. At the three-month visit, eight patients exhibited symptoms of rectal mucus discharge, which were considered mid-term complications. In the final examination at six months, four patients experienced prolapse recurrences. Conclusions: Based on the findings, it can be concluded that perirectal sclerotherapy using a 50% dextrose injection is an effective primary surgical procedure for rectal prolapse in children under 14 years of age. The treatment is simple, inexpensive, and associated with minimal risk of complications and short recovery times compared to open surgery.