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Posterior sagittal anorectoplasty for pediatric recurrent rectal prolapse
R H Pearl1, S H Ein, B Churchill
1Division of General Surgery, Hospital for Sick Children, Toronto, Ontario, Canada.
Journal of Pediatric Surgery
|October 1, 1989
Summary
Posterior sagittal anorectoplasty effectively repaired recurrent rectal prolapse in a young girl. This surgical technique offers advantages over previous methods for complex cases.
Area of Science:
- Pediatric surgery
- Colorectal surgery
- Reconstructive surgery
Background:
- Posterior sagittal anorectoplasty (PSARP) is established for high imperforate anus repair.
- Recurrent rectal prolapse in children can be challenging to manage.
- Bladder exstrophy can be associated with rectal prolapse due to abdominal pressure.
Observation:
- A 1-year-old girl presented with recurrent rectal prolapse and bladder exstrophy.
- Previous attempts using the subcutaneous Thiersch's perianal technique failed within 6 weeks.
- The patient's rectal prolapse was severe, admitting two fingers.
Findings:
- PSARP was successfully employed to repair the recurrent rectal prolapse concurrently with bladder exstrophy repair.
- The procedure involved a midline sacrococcygeal incision, rectal plication, and reapproximation of the levator sling.
- The repair remained intact at 1-year follow-up.
Implications:
- PSARP is a viable and effective option for managing recurrent rectal prolapse, even in complex pediatric cases.
- This technique may offer superior outcomes compared to traditional methods for rectal prolapse.
- Successful concurrent repair of rectal prolapse and bladder exstrophy demonstrates the versatility of PSARP.