Thiersch's operation for rectal prolapse in infants and children

Oeconomopoulos, Chris T.; Swenson, Orvar

doi:10.1016/0002-9610(60)90388-3

Cited by 11 publications

(9 citation statements)

References 3 publications

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“…These data are similar to the results of other surgical procedures including posterior repair and suspension [3,4], Ekehorn rectosacropexy [5], transabdominal rectopexy with omental flap [6], sclerotherapy [7], and Thiersch cerclage [8]. Several case reports [9,10] and one case-control series [11] using laparoscopic rectopexy in children have also demonstrated excellent results with few complications.…”

Section: Discussionsupporting

confidence: 84%

Laparoscopic suture rectopexy for full-thickness anorectal prolapse in children: an effective outpatient procedure

Potter¹,

Bruny²,

Allshouse³

et al. 2010

Journal of Pediatric Surgery

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Section: Discussionsupporting

confidence: 84%

Laparoscopic suture rectopexy for full-thickness anorectal prolapse in children: an effective outpatient procedure

Potter¹,

Bruny²,

Allshouse³

et al. 2010

Journal of Pediatric Surgery

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“…For children with persistent RP, several surgical/procedural options exist. The four most commonly cited include sclerotherapy, Thiersch's anal cerclage, [39][40][41] Ekehorn's rectosacropexy, 34 transabdominal sacral rectopexy with or without sigmoid resection, 42,43 and sacral rectopexy through a posterior incision. 42 Importantly, operative and procedural therapies that are often successful in children younger than 4 years do not have the same success rate in older children, likely due to a difference in the comorbidities and etiology.…”

Section: Managementmentioning

confidence: 99%

Pediatric Rectal Prolapse

Rentea

Peter

2018

Clinics in Colon and Rectal Surgery

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Rectal prolapse is a common and self-limiting condition in infancy and early childhood. Most cases respond to conservative management. Patients younger than 4 years with an associated condition have a better prognosis. Patients older than 4 years require surgery more often than younger children. Multiple operative and procedural approaches to rectal prolapse exist with variable recurrence rates and without a clearly superior operation. These include sclerotherapy, Thiersch's anal cerclage, Ekehorn's rectopexy, laparoscopic suture rectopexy, and posterior sagittal rectopexy.

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“…Injection sclerotherapy is the most popular and well-known minimally invasive procedure for initial management of rectal prolapse in the pediatric population [1–4], while other minimally invasive procedures described in the literature include the Thiersch anal encirclement [5, 6], linear cauterization [7], and packing of the presacral space with various materials [8]. More invasive options described include: transsacral rectopexy [9, 10], transcoccygeal rectopexy [11], posterior sagittal anorectoplasty [12], and perineal proctosigmoidectomy (Altemeier procedure) [13], If little is known about the optimal initial operative management for refractory rectal prolapse, far less is known about the best management approach following failure of the primary operative procedure, with only cases of recurrence following failure of injection sclerotherapy [14] and linear cauterization [7] being reported.…”

Section: Introductionmentioning

confidence: 99%

Recurrent rectal prolapse following primary surgical treatment

2010

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Purpose-The management of recurrent rectal prolapse following initial surgical procedures remains unclear. We present a series of pediatric patients with rectal prolapse and describe their surgical management, and the subsequent care for those children developing recurrence.Methods-The records of 29 pediatric patients with rectal prolapse refractory to conservative medical management who were managed with primary modified Thiersch procedures over a 14-year period were reviewed. Initial surgical management consisted of a modified version of the Thiersch anal encirclement procedure, which involved a combination of injection sclerotherapy, linear cauterization, and placement of a Thiersch anal encirclement absorbable stitch. Age at initial procedure, predisposing conditions, complications, recurrence, time to recurrence, and subsequent procedures utilized were reviewed.Results-Of 29 patients, 22 (71%) were male with a mean age at time of first Thiersch procedure of 7.1 years (range 3 months to 19 years). Seven patients were lost to follow-up. Nineteen patients (90%) experienced resolution of their prolapse following one or two modified Thiersch procedures; 14 (67%) following an initial Thiersch and 5 (23%) following a subsequent Thiersch. One additional child experienced recurrence after an initial Thiersch procedure, and underwent a perineal resection of redundant rectum (modified Altemeier procedure). Two patients developed a recurrence after their second Thiersch. These cases both required a modified Altemeier procedure. Mean follow-up for all patients was 1.5 years.Conclusion-For pediatric rectal prolapse refractory to conservative medical therapy, the modified Thiersch procedure appears reasonable. Initial recurrences are not uncommon, and their incidence increases with the age of the child. Recurrences should be initially managed by a repeat Thiersch procedure. However, subsequent recurrences should be treated with a modified Altemeier.

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Thiersch's operation for rectal prolapse in infants and children

Cited by 11 publications

References 3 publications

Laparoscopic suture rectopexy for full-thickness anorectal prolapse in children: an effective outpatient procedure

Laparoscopic suture rectopexy for full-thickness anorectal prolapse in children: an effective outpatient procedure

Pediatric Rectal Prolapse

Recurrent rectal prolapse following primary surgical treatment

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