Background
Rectal prolapse in children is common in developing countries with low health
resources. Open and laparoscopic abdominal approaches are ideal for the
treatment of rectal prolapse but they are not suitable for frail children and
countries with poor medical resources. Perineal procedures are usually well
tolerated and simple but have high recurrence rates.
Objective
Our objective is to assess the short-term outcomes of combined minimally invasive
perineal procedures, including anal encirclement, submucosal alcohol injection,
and Gant–Miwa procedure, in the management of full-thickness rectal prolapse in
children. Through this combination, we looked forward toward magnifying the
advantages of perineal procedures and allaying their complications, particularly
recurrence rates.
Patients and methods
A total of 31 children with complete rectal prolapse were recruited during the period
from May 2017 to June 2019. All the patients underwent three combined perineal
procedures: mucosal plication (Gant’s technique), anal encirclement, and
submucosal injection sclerotherapy.
Results
The study group included children with a median age of 6.55±2.14 years (range,
3.0–10.0 years). Mean operative time was 37.58±5.61 min (range, 30.0–45.0 min).
The end results of our study were renovating anorectal physiology by correcting the
rectal prolapse and improving continence (93.5%) and constipation (93.5%), with
no mortality (0%) and low recurrence rates (3.2%).
Conclusion
Our approach (combined minimally invasive perineal procedures) is simple,
effective, and less invasive, with minimal morbidity and a negligible recurrence
rate, particularly for children with complete rectal prolapse. |
