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Management of rectal prolapse in children: Ekehorn's rectosacropexy
1Department of Pediatric Surgery, SSK Bakirköy Doğumevi, Kadin ve Cocuk Hastaliklari Eğitim Hastanesi, Cocuk Cerrahisi Kliniği, Istanbul, Turkey.
Insights
Surgical treatment for pediatric rectal prolapse (RP) can be confusing. Ekehorn's transanal suture rectosacropexy technique effectively treated 56 children with complete RP, showing no recurrences in long-term follow-up.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Rectal prolapse (RP) in children often requires surgical intervention, but indications and techniques lack clarity.
- Existing surgical approaches for pediatric RP present challenges regarding standardization and efficacy.
Purpose of the Study:
- To evaluate the efficacy and safety of Ekehorn's transanal suture rectosacropexy for treating complete rectal prolapse in children.
- To advocate for clearer surgical indications for pediatric rectal prolapse.
Main Methods:
- A retrospective review of 56 children (36 boys, 20 girls; average age 4.5 years) treated with Ekehorn's technique between 1987 and 1998.
- The technique involves a single U-shaped suture through the rectal ampulla, secured at the sacrococcygeal junction.
- Follow-up periods ranged from 1 to 10 years.
Main Results:
- No recurrences of rectal prolapse were observed in any of the 56 treated children.
- The procedure demonstrated a high success rate with a simple, effective surgical method.
- The average duration of prolapse prior to treatment was 3 to 8 months.
Conclusions:
- Ekehorn's transanal suture rectosacropexy is a simple and effective surgical option for pediatric complete rectal prolapse.
- Further definition of surgical indications for pediatric rectal prolapse is warranted.
- The technique offers a promising solution with a zero-recurrence rate in this cohort.
Abstract:
Although surgical intervention is occasionally required for rectal prolapse (RP), there is both vagueness as to the indications for surgery and confusion as to the technique that should be used for children who need surgical treatment. Using Ekehorn's transanal suture rectosacropexy technique, 56 children with RP were treated surgically between 1987 and 1998 at our hospital. There were 36 boys and 20 girls, the average age was 4.5 years, and the duration of the recurrent prolapse prior to admission ranged from 3 to 8 months. The technique consists of simply inserting one "U"-shaped suture through the rectal ampulla and tying the strands of the suture outside at the level of the sacrococcygeal junction. In this series, follow-up periods ranged from 1 to 10 years and there were no recurrences. We believe that surgical indications for RP need to be defined more clearly and that Ekehorn's technique offers a simple and effective method for the surgical treatment of complete RP in children.
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