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Laparoscopic Suture Rectopexy for Persistent Rectal Prolapse in Children: Is It a Safe and Effective First-Line
Karim Awad1, Mohamed El Debeiky1, Amr AbouZeid1
1Pediatric Surgery Department, Ain Shams University , Cairo, Egypt .
Insights
Laparoscopic suture rectopexy (LSRP) is a safe and effective minimally invasive treatment for pediatric rectal prolapse, offering a short hospital stay and low recurrence rates.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
Background:
- Rectal prolapse surgical correction lacks a definitive superior technique.
- Laparoscopic suture rectopexy (LSRP) is evaluated for pediatric rectal prolapse.
Purpose of the Study:
- To assess the safety and efficacy of LSRP in children with rectal prolapse.
Main Methods:
- Prospective data collected for children undergoing surgery for rectal prolapse (2011-2014).
- All patients underwent LSRP with rectal fixation to the sacral promontory.
- Median follow-up was 14 months.
Main Results:
- Twenty children (27%) underwent LSRP, with a median age of 4.4 years.
- Median operative time was 77.5 minutes; median hospital stay was 1 day.
- One full-thickness recurrence and one mucosal prolapse occurred.
Conclusions:
- LSRP is a safe and effective treatment for pediatric full-thickness rectal prolapse.
- Benefits include minimally invasive approach, short hospital stay, and early recovery.
- Low recurrence rates observed with LSRP in this pediatric cohort.
Background:
Several techniques have been described for the surgical correction of rectal prolapse without any clear advantage for one technique over the other. We evaluated the use of laparoscopic suture rectopexy (LSRP) as a modality of treatment for rectal prolapse in children.
Materials And Methods:
Prospective data were collected for all children who presented to our center between 2011 and 2014 and required surgery for rectal prolapse. All children underwent LSRP with fixation of the mobilized rectum to the sacral promontory with multiple nonabsorbable sutures. The median follow-up period was 14 months (range, 6-29 months). The operative time, operative complications, length of hospital stay, and postoperative complications were recorded and analyzed.
Results:
Seventy-four patients presented with rectal prolapse during this period. Twenty patients (27%) required LSRP. Their median age at surgery was 4.4 years (range, 2-11 years), median operative time was 77.5 minutes (range, 30-150 minutes), and the median length of hospital stay was 1 day (range, 1-4 days). Only 1 patient had full-thickness recurrence that required redo surgery, and another had mucosal prolapse, which spontaneously resolved.
Conclusions:
LSRP is a safe and effective technique for treating children with full-thickness rectal prolapse with the benefits of being minimally invasive, a short hospital stay, early recovery, and low recurrence rate.
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