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Outcomes following sclerotherapy for mucosal rectal prolapse with oily phenol injection: single-centre review
Rohini Sahay1, Govind Murthi2, Richard Lindley2
1Sheffield Children's Hospital, Sheffield, UK. rohini.sahay9@gmail.com.
Insights
Injection sclerotherapy with oily phenol is a safe, effective treatment for mucosal rectal prolapse. Recurrence rates were 30.4%, necessitating careful re-evaluation before repeat injections.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Colorectal Surgery
Background:
- Mucosal rectal prolapse is a common condition in children.
- Conservative management is often the first line of treatment.
- Surgical intervention may be required for refractory cases.
Purpose of the Study:
- To review the outcomes of injection sclerotherapy using oily phenol for mucosal rectal prolapse in children.
- To assess the efficacy and safety of this minimally invasive procedure.
Main Methods:
- Retrospective review of pediatric patients treated with oily phenol injection for mucosal rectal prolapse between January 2007 and December 2015.
- Exclusion of patients with full-thickness rectal prolapse or those who had a Thiersch stitch.
- Analysis of recurrence rates and follow-up data.
Main Results:
- 23 children with mucosal rectal prolapse underwent injection sclerotherapy.
- The mean age at presentation was 4.8 years.
- A recurrence rate of 30.4% was observed, requiring further intervention.
Conclusions:
- Injection sclerotherapy with oily phenol is a safe and effective primary treatment for mucosal rectal prolapse unresponsive to conservative measures.
- Recurrence warrants careful re-examination under anesthesia to rule out missed full-thickness prolapse prior to repeat injection.
Aim Of The Study:
To review the outcomes of injection sclerotherapy with oily phenol for mucosal rectal prolapse.
Methods:
Retrospective case note review of all children who underwent sclerotherapy with oily phenol injection as primary surgical intervention for mucosal rectal prolapse, from January 2007 to December 2015.
Main Results:
A total of 31 patients were identified. Mean age at presentation was 4.8 years (range 5 months-12 years). 23 patients with mucosal rectal prolapse underwent injection sclerotherapy with oily phenol as primary procedure. Patients with full-thickness rectal prolapse (n = 6) and 2 with mucosal prolapse who had Thiersch stitch were excluded from the study. The cause for mucosal rectal prolapse was considered to be due to constipation (n = 15), idiopathic (n = 7), spina bifida (n = 1). Follow-up was for minimum 6 months (median = 4 years; range 6 months-17 years). Recurrence following injection sclerotherapy with oily phenol requiring further procedures was 30.4% (7/23).
Conclusions:
Injection sclerotherapy with oily phenol is a safe, effective and minimally invasive primary treatment option for mucosal rectal prolapse not responding to conservative management. In case of recurrence, a cautious re-examination under anaesthesia should be undertaken to exclude a missed full-thickness rectal prolapse before reinjecting.
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