Transanal endorectal approach for the treatment of idiopathic rectal prolapse in children: Experience with the modified Delorme's procedure

Abstract

Background: Persistent or recurrent idiopathic rectal prolapse in children requires surgical intervention. Several techniques have been used to repair this problem. However, recurrence and complications continue to be a challenge in the management of this condition. Here we report our experience in using the modified Delorme's procedure to treat such patients. Methods: We conducted a retrospective observational study of patients with idiopathic rectal prolapse who underwent the modified Delorme's procedure during 2013-2017. We analyzed the clinical characteristics of the patients and the recurrence and complication rates during a follow-up of 15-68 months. Results: We included 14 patients. The age at operation ranged from 2 to 17 years, and the length of the prolapse was 3-15 cm. There were no intraoperative or postoperative complications. All patients achieved postoperative fecal control, and there were no recurrences. Conclusion: The modified Delorme's procedure was effective for the treatment of idiopathic rectal prolapse. There were no recurrences or complications. Because it is a perineal technique, the procedure avoids the risk of nerve injury that exists for transabdominal methods.

To Explore the Efficacy of Modified Altemeier Procedure in the Treatment of Complete Rectal Prolapse

“…This approach can significantly improve the patient's fecal symptoms such as anal incontinence and constipation. Finally, the modified Altemeier procedure was combined with anal levatorplasty to close the posterior anal triangle gap, correct the anatomical defect of anal levator separation, induce anterior displacement of the anus, sharpen the anorectal angle, and restore the normal structure of the anorectum, which plays a more active role in preventing fecal incontinence caused by prolapse [18] . In this study, not only the Wexner score was significantly lower in the modified group than in the traditional group, but also the postoperative quality of life score and the incidence of perioperative complications were significantly lower than that in the traditional group, suggesting that the modified Altemeier has significant advantages in terms of both improving the treatment effect and reducing complications.…”