Rectal prolapse: 17-year experience with the posterior repair and suspension

Ashcraft, Keith W.; Garred, John; Holder, Thomas M.; Amoury, Raymond A.; Sharp, Ronald J.; Murphy, John P.

doi:10.1016/0022-3468(90)90245-5

Cited by 41 publications

(30 citation statements)

References 5 publications

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“…Many surgical procedures to contain rectal prolapse in children are advocated but without any coherent evidence-based approach. Surgical procedures ranging from the less invasive injection sclerotherapy [3] to more aggressive surgery, including abdominal posterior rectopexy [4], abdominal or perineal bowel resection [5], transanal suture rectosacropexy [6], and posterior sagittal procedures [7] have been described. The large number of described procedures lacks consensus and evidence to reflect their success in all cases of rectal prolapse in children.…”

Section: Introductionmentioning

confidence: 99%

Persistent rectal prolapse in children: sclerotherapy and surgical management

et al. 2005

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Persistent rectal prolapse is an uncommon but distressing condition in children. Significant controversy exists regarding its surgical management. The aim of this study was to identify a successful management strategy for persistent rectal prolapse in the paediatric population. Records of all children with rectal prolapse treated surgically at Birmingham Children's Hospital between 1995 and 2003 were retrospectively reviewed. Demographic data, clinical presentation, investigations, treatment modality, complications, and outcome were recorded. Inclusion criteria for the study were failure of conservative management leading to operative treatment. An exclusion criterion was cystic fibrosis. A total of 24 patients with persistent rectal prolapse were identified. Two children with cystic fibrosis were excluded from the analysis. Children below the age of 5 years, group I (n=17), were successfully managed by submucous hypertonic saline injections. Eighty-three percent (14/17) were cured by injection sclerotherapy in this group, 12/14 (71%) requiring one injection and 2/14 requiring a second injection. In the three (17.6%) children in group I in whom sclerotherapy failed, cow's milk protein (CMP) allergy was identified as the causative factor. Children older than 5, group II (n=5), either had behavioural problems (n=3) or were autistic (n=2). This group of children with adult-type, full-thickness rectal prolapse were found to be refractory to initial attempts of injection sclerotherapy. All five children were successfully managed with surgical correction. We conclude that rectal submucous hypertonic saline injections are highly effective for managing early-onset idiopathic childhood rectal prolapse. CMP allergy should be considered in young children with recurrent rectal prolapse. We recommend early definitive corrective surgery in older children with persistent rectal prolapse, as they do not respond to conservative measures or injection sclerotherapy.

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Section: Introductionmentioning

confidence: 99%

Persistent rectal prolapse in children: sclerotherapy and surgical management

et al. 2005

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“…It can also occur in diarrhea and in children with malnutrition. Mechanical factor such as sacral hypoplasia in bladder exstrophy and high anorectal anomaly may play a rule 12 . Although there is no optimal or standerd procedure for treatment of rectal prolapse, initial treatment typically includes stool softeners, prevents straining during defaecation, treatment of diarrhoea and correction of malnutrition.…”

Section: Discussionmentioning

confidence: 99%

“…The trend in managing pediatric rectal prolapse has been moving away from extensive surgery. Injection sclerotherapy using various agents has been recommended by various investigators [9][10][11][12] .…”

Section: Introductionmentioning

confidence: 99%

Injection Sclerotherapy with 5% Phenol in Almond Oil in the Treatment of Rectal Prolapse in Children: Our Experience

Hoque

Ahmed

Nandy

2017

Chatt Maa Shi Hosp Med Coll J

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Background: Rectal prolapse is a relatively common condition in children. A wide variety of sclerosing agents have been used in the treatment of rectal prolapse in children. We have used 5 % phenol in almond oil in the treatment of rectal prolapse in our children. The aim of this study was to find out the outcome of injection sclerotherapy with 5% phenol in almond oil in the treatment of rectal prolapse in children. Methods: From May 2009 to December 2016 a total of 186 patients with rectal prolapse were treated by injection sclerotherapy with 5% phenol in almond oil. Of which males were 112 and females 74. Age ranged from 1.5 years to 7 years. Initial management included assessment and correction of predisposing factors. If the rectal prolapse persisted or if the prolapse required repeated reduction, injection sclerotherapy was performed. Number of injections, recurrences, and complications were reviewed. Results: Out of 186 patients recurrence occurred in 12 patients, cured after second injection in 10 patients and 2 children needs Thiersch's stitch. Excessive oozing at the injection site was in 5 patients. Conclusion: Injection sclerotherapy with 5% phenol in almond oil is simple, safe and effective treatment of recurrent rectal prolapse after failure to conservative measures.

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“…The suggested treatment in pediatric patients is laparoscopic rectopexy to the sacrum, [15][16][17] with all its benefits of less pain and quick recovery. Patients with spinal dysraphias have an associated lax rectosigmoid, and this can cause partial or total prolapse of the anterior wall, which is not fixed, producing invagination at the level of the rectosigmoid and recurrence by this mechanism [7,12]. This is why we propose, in addition to rectopexy, fixation of the anterior border of the rectosigmoid to the lateral wall of the pelvic hollow as a way to avoid relapse.…”

Section: Discussionmentioning

confidence: 99%

“…Relapse is an indication for surgery [4]. The incidence of rectal prolapse associated to spinal dysraphia that requires surgical treatment varies in published series from 5.3% to 40% [5][6][7][8]. Multiple surgical techniques have been described as successful treatment of rectal prolapse; [9][10][11][12] however, recurrence is frequent in patients with associated neuromuscular pathology [8].…”

mentioning

confidence: 99%

Sigmoid fixation associated with rectopexy using a laparoscopic approach could prevent relapse of rectal prolapse in pediatric patients with spinal dysraphia

Montes-Tapia

Cura-Esquivel

Garza-Luna

et al. 2008

Journal of Pediatric Surgery

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Recurrent rectal prolapse, resistant to medical treatment, is an indication for surgical treatment. Patients with spinal dysraphia frequently have already been treated by sclerotherapy or other surgical techniques, but unsuccessfully. Methods: We present 2 patients, who underwent laparoscopic rectopexy, with spinal dysraphia and complete rectal prolapse relapse after conservative treatment. In these patients, we performed, as an additional technique, fixation of the rectosigmoid to avoid recurrence by invagination or prolapse of the anterior wall. Results: Follow-up at 14 and 11 months, respectively, did not find any recurrence. Conclusion: We suggest that laparoscopic rectopexy with sigmoid fixation should be considered as an alternative for the treatment for patients with spinal dysraphia and rectal prolapse to avoid recurrence.

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Rectal prolapse: 17-year experience with the posterior repair and suspension

Cited by 41 publications

References 5 publications

Persistent rectal prolapse in children: sclerotherapy and surgical management

Persistent rectal prolapse in children: sclerotherapy and surgical management

Injection Sclerotherapy with 5% Phenol in Almond Oil in the Treatment of Rectal Prolapse in Children: Our Experience

Sigmoid fixation associated with rectopexy using a laparoscopic approach could prevent relapse of rectal prolapse in pediatric patients with spinal dysraphia

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